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MSCC 24-hour — SCE Medical Oncology MCQ

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HardOncological EmergenciesMSCC 24-hourSCE Medical Oncology

MRI confirms metastatic spinal cord compression. Spinal surgery is not suitable, the patient was ambulant yesterday, and prognosis is measured in months. What radiotherapy arrangement best follows NICE NG234?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Arrange radiotherapy within 24 hours, usually as a single 8 Gy fraction

For MSCC unsuitable for surgery, NG234 recommends urgent radiotherapy as soon as possible and within 24 hours. A single 8 Gy fraction is usual unless toxicity risk from a large field favours multiple fractions. Steroids do not justify delay, and SABR is not the routine emergency default.

Reference: NICE NG234: spinal metastases and metastatic spinal cord compression. https://www.nice.org.uk/guidance/ng234/chapter/recommendations