THE RADIATION-INDUCED MYELOPATHY: CASE REPORT

Although radiation-induced myelopathy is rare condition in practice of oncology, which is most tragic complications of radiotherapy is discussed by means of two cases. The first patient with stage IV cervical esophageal cancer was treated by surgery and postoperative irradiation. The cervical segment of medullo spinalis was received 4000 cGy/20 fraction/4 weeks radiation and developed symptoms and signs of late radiation myelopathy after thirteen months of irradiation. Spinal MRI showed appearance of radiation-induced myelopathy. His myelopathy has been found due to not to use tissue compensatory filter over the neck region during radiotherapy. Fortunately, myelopathy was not progressed and he has completed 5 years of followed-up. The second patient with medically inoperable bronchial carsinoma was treated with primary radiotherapy. Her thoracic segment of spinal cord was received 5500 cGy/22 fr/4.5 weeks (250 cGy/fraction). Radiation and developed progressive radiation myelopathy 20 months after treatment. She was died 44 months later with complications of radiation-induced myelopathy. These case reports reindicade the importance of not to exceed the radiation tolerance of spinal cord.

Keywords: radiation myelopathy, case reports