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Effect of radiotherapy on local control and overall survival in spinal metastasis of non-small-cell lung cancer after surgery and systemic therapy – Lumbar Spinal Stenosis

The article investigated the efficacy of post-surgical radiotherapy for spinal metastatic non-small-cell lung cancer (NSCLC) patients who underwent surgery followed by systemic therapy. The study found that radiotherapy had little effect in improving local control (LC), overall survival (OS), or quality of life in these patients. Factors such as histological type, targeted therapy, abnormal laboratory data, and lesion location were associated with outcomes. The research concluded that tumour histological type significantly influences the prognosis in spinal NSCLC metastasis patients, and radiotherapy may not be as effective in improving outcomes in these individuals

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine facility in London

Published article

CONCLUSION: Tumour histological type was significantly associated with the prognosis in spinal NSCLC metastasis patients. In the presence of post-surgical systemic therapy, radiotherapy appeared to be less effective in improving LC, OS, or quality of life in spinal NSCLC metastasis patients.

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Bone Jt Open. 2024 Apr 23;5(4):350-360. doi: 10.1302/2633-1462.54.BJO-2024-0037.R1. ABSTRACT AIMS: Radiotherapy is a well-known local treatment for spinal metastases. However, in the presence of postoperative systemic therapy, the efficacy of radiotherapy on local control (LC) and overall survival (OS) in patients with spinal metastases remains unknown. This study aimed to evaluate the clinical outcomes of,

Bone Jt Open. 2024 Apr 23;5(4):350-360. doi: 10.1302/2633-1462.54.BJO-2024-0037.R1.

ABSTRACT

AIMS: Radiotherapy is a well-known local treatment for spinal metastases. However, in the presence of postoperative systemic therapy, the efficacy of radiotherapy on local control (LC) and overall survival (OS) in patients with spinal metastases remains unknown. This study aimed to evaluate the clinical outcomes of post-surgical radiotherapy for spinal metastatic non-small-cell lung cancer (NSCLC) patients, and to identify factors correlated with LC and OS.

METHODS: A retrospective, single-centre review was conducted of patients with spinal metastases from NSCLC who underwent surgery followed by systemic therapy at our institution from January 2018 to September 2022. Kaplan-Meier analysis and log-rank tests were used to compare the LC and OS between groups. Associated factors for LC and OS were assessed using Cox proportional hazards regression analysis.

RESULTS: Overall, 123 patients with 127 spinal metastases from NSCLC who underwent decompression surgery followed by postoperative systemic therapy were included. A total of 43 lesions were treated with stereotactic body radiotherapy (SBRT) after surgery and 84 lesions were not. Survival rate at one, two, and three years was 83.4%, 58.9%, and 48.2%, respectively, and LC rate was 87.8%, 78.8%, and 78.8%, respectively. Histological type was the only significant associated factor for both LC (p = 0.007) and OS (p < 0.001). Treatment with targeted therapy was significantly associated with longer survival (p = 0.039). The risk factors associated with worse survival were abnormal laboratory data (p = 0.021), lesions located in the thoracic spine (p = 0.047), and lumbar spine (p = 0.044). This study also revealed that postoperative radiotherapy had little effect in improving OS or LC.

CONCLUSION: Tumour histological type was significantly associated with the prognosis in spinal NSCLC metastasis patients. In the presence of post-surgical systemic therapy, radiotherapy appeared to be less effective in improving LC, OS, or quality of life in spinal NSCLC metastasis patients.

PMID:38649150 | DOI:10.1302/2633-1462.54.BJO-2024-0037.R1

The London Spine Unit : best recognised spine facility in London

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Effect of radiotherapy on local control and overall survival in spinal metastasis of non-small-cell lung cancer after surgery and systemic therapy

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Bone Jt Open. 2024 Apr 23;5(4):350-360. doi: 10.1302/2633-1462.54.BJO-2024-0037.R1. ABSTRACT AIMS: Radiotherapy is a well-known local treatment for spinal metastases. However, in the presence of postoperative systemic therapy, the efficacy of radiotherapy on local control (LC) and overall survival (OS) in patients with spinal metastases remains unknown. This study aimed to evaluate the clinical outcomes of

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