2019
DOI: 10.1016/j.adro.2018.10.007
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Outcomes in the radiosurgical management of metastatic spine disease

Abstract: Purpose Stereotactic body radiation therapy (SBRT) is a common treatment option for patients with metastatic tumors of the spine. The optimal treatment-, tumor-, and patient-specific characteristics necessary to achieve durable outcomes remain less well understood given the heterogeneous nature of the patient population this modality typically serves. The objective of this analysis was to better understand the determinants underlying SBRT spine treatment outcomes. Methods and Materi… Show more

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Cited by 15 publications
(14 citation statements)
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“…Osteolytic destruction most commonly occurs in patients with metastatic spinal cancer. Pathological fracture of the spine is caused by tumor invasion of the vertebral body and its appendages, resulting in severe pain in the lower back, spinal dysfunction, neurological dysfunction, and paraplegia, seriously affecting the quality of life [ 2 ]. Traditional surgery or chemoradiotherapy for spinal metastatic cancer causes severe trauma and various complications and has narrow application range and poor efficacy [ 3 ].…”
Section: Introductionmentioning
confidence: 99%
“…Osteolytic destruction most commonly occurs in patients with metastatic spinal cancer. Pathological fracture of the spine is caused by tumor invasion of the vertebral body and its appendages, resulting in severe pain in the lower back, spinal dysfunction, neurological dysfunction, and paraplegia, seriously affecting the quality of life [ 2 ]. Traditional surgery or chemoradiotherapy for spinal metastatic cancer causes severe trauma and various complications and has narrow application range and poor efficacy [ 3 ].…”
Section: Introductionmentioning
confidence: 99%
“…Compared with metal, carbon fiber implants have minimal dose perturbation effects resulting in negligible backscattering and attenuation allowing for improved ability to detect tumor recurrence, precise preradiation CT planning with minimal artifacts, and reduce interference with post-reconstructive adjuvant radiotherapy. [14][15][16][17][18][19][20][21][22] Contouring and range calculation for patients' with PEEK/CF stabilization devices show almost negligible image artifacts, which reduces contouring uncertainties and increase the accuracy of dosimetric treatment planning. 22 PEEK/CF stabilization devices may therefore be considered more suitable than commonly-used titanium devices especially when considering adjuvant particle therapy.…”
Section: Discussionmentioning
confidence: 99%
“…Metal artifact from titanium implants adversely affects the quality of postoperative imaging. 5,[15][16][17] This remains a challenge since the quality of postoperative imaging is directly related to the ability to identify tumor recurrence, and for planning and delivery of radiotherapy treatments. This is particularly important, since newer radiotherapy techniques, such as accelerated heavy ion particles (proton and carbon) can concentrate even higher radiation doses, but are also more significantly compromised by titanium constructs.…”
mentioning
confidence: 99%
“…Spinal misalignment has also been frequently found in patients experiencing VCF,27,36,40 as well as pre-existing VCF 27,34,4043. Put together, all these factors may participate in global mechanical instability of the vertebra, that is of particular concern since it has been correlated both to VCF onset and to local failure: interestingly, Kelley et al reported superior local control after single-fraction SBRT with a median dose of 16 (16–20) Gy as compared to hypofractionated SBRT 44. Mechanical instability of vertebra should be constantly addressed in patients potentially eligible for SBRT in order to select candidates for this option and predict the risk of complications.…”
Section: Spinal Metastasesmentioning
confidence: 99%