Delays from symptom onset to treatment in malignant spinal cord compression: Quantification and effect on pre-treatment neurological status.

8276 Background: Malignant spinal cord compression (MSCC) is a devastating complication of advanced malignancy. Any delay in initiation of radiation treatment may result in a deterioration of pre-treatment neurological function; hence, a poorer prognosis of post treatment outcome and quality of life. A British study documented significant delays in patients with MSCC, the majority losing neurological function as a result. The objective of this study was to prospectively document patterns of care from symptom onset of MSCC until initiation of radiation treatment at our centre, and investigate potential affects on pre-treatment neurological status. METHODS A standardized data collection form was used to document demographics, tumor and functional information; and centre and referring doctors' charts were used to augment patient history. Chi-squared analysis and Person's r correlation determined statistical significance. Thirty patients identified from Jan/03-Dec/03 were accrued. Three subgroups were formed based on time from symptom onset until RT treatment: 0-7 days, 8-14 days, and >14 days. RESULTS A median delay of 16 days from symptom onset till RT treatment was experienced, of which 90% resulted from symptom onset to initiation of medical attention. When patients perceived symptoms to be related to their previous cancer the median time delay was 6 days, compared to 7 days when patients related symptoms to other co-morbidities. CONCLUSIONS Deterioration of symptoms was strongly correlated with time delay in patients with MSCC at our centre, thereby supporting prevention and educational strategies to help reduce the impact of this complication on patients with advanced cancer. No significant financial relationships to disclose.