The Evolving Treatment Paradigm for Metastatic Spine Disease

Blakaj, Dukagjin; Guiou, Michael; Weicker, Michael A.; Mendel, Ehud

doi:10.1016/j.wneu.2015.02.014

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…In PPSF without surgical decompression, radiosensitive metastatic tumors were indirectly decompressed through EBRT. The radiation dose in palliative therapy is typically 20–40 Gy, with 2–4 Gy per fraction [ 37 ]. The optimized course of radiotherapy is still under investigation.…”

Section: Discussionmentioning

confidence: 99%

Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

Chi¹,

Ho²,

Chiu³

et al. 2022

Biomedical Journal

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Section: Discussionmentioning

confidence: 99%

Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

Chi¹,

Ho²,

Chiu³

et al. 2022

Biomedical Journal

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“…Spinal metastases often cause severe morbidity and adversely affect quality of life because of pain, pathologic fractures, and spinal cord compression [ 2 , 3 ]. Treatment options for spinal metastases include surgery, radiotherapy (RT), and systemic therapy, such as bisphosphonates; the goal of these modalities is palliation of pain, maintenance of spinal stability, prevention of neurologic deficit, and slowing of local disease progression [ 4 , 5 ]. RT, the most common strategy for spinal metastases, has been reported to provide significant palliation of pain in approximately 60% to 90% of patients, with up to 33% of individuals achieving complete pain response at the irradiated site [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The 18F-FDG PET/CT response to radiotherapy for patients with spinal metastasis correlated with the clinical outcomes

et al. 2018

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PurposeTo evaluate the potential role of 18F-fluorodeoxyglucose-positron emission tomography/computerized tomography (FDG-PET/CT) for predicting treatment response after radiotherapy (RT) in patients with spinal metastases.Materials and methodsA retrospective analysis was performed of 42 patients with spinal metastases who received RT from January 2010 to December 2014. All patients underwent FDG-PET/CT before and after treatment. Changes in metabolic responses, expressed as the maximum, mean, peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were analyzed to determine their association with clinical outcomes.ResultsThe median age at the time of spinal metastasis diagnosis was 58 years. Median progression-free survival (PFS) and overall survival after RT were 15 months and 22.4 months, respectively. RT produced a significant decrease in SUVmean (2.27 to 1.41), SUVmax (6.87 to 2.99), SUVpeak (5.75 to 2.33) and TLG (52.84 to 24.17) when compared with the baseline values (p<0.001). The mean pain score decreased from 3.86 before RT to 0.79 after RT (p<0.001). There were significant linear relationships between maximum SUV and pain scores at baseline (r = 0.321, p = 0.038) and after treatment (r = 0.369, p = 0.016) as well as TLG at baseline (r = 0.428, p = 0.005) and after treatment (r = 0.403, p = 0.009). Local progression after treatment was identified in 12 patients (28.6%). Univariate analyses showed that >70% reduction in maximum SUV after treatment was independently associated with good PFS (p = 0.036).ConclusionsRT is an effective treatment for patients with spinal metastases, and there were significant changes in PET parameters compared with baseline. The metabolic response measured by SUV and TLG changes in FDG-PET/CT correlated with the clinical outcomes, especially with shorter PFS in patients who had higher residual maximum SUV after treatment.

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The Evolving Treatment Paradigm for Metastatic Spine Disease

Cited by 2 publications

References 14 publications

Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

The 18F-FDG PET/CT response to radiotherapy for patients with spinal metastasis correlated with the clinical outcomes

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