Is surgery required in the management of spinal cord compression in myeloma patients?

摘要

Sir - We enjoyed the recent review by Akram and Alli-bone [1] regarding the use of spinal surgery in palliating malignant spinal cord compression (MSCC). The authors suggest that an aggressive surgical approach should be considered with tumours with a favourable prognosis, and quote myeloma as having the longest median survival of 35 months in the setting of MSCC. However, myeloma is considered a radiosensitive malignancy, and we wish to highlight evidence suggesting that radiotherapy alone is nearly always the optimal treatment for MSCC due to myeloma.