Postoperative re-irradiation utilizing stereotactic physique radiotherapy for metastatic epidural spinal wire compression.
J Neurosurg Backbone. 2018 Jun 15;:1-7
Authors: Ito Ok, Nihei Ok, Shimizuguchi T, Ogawa H, Furuya T, Sugita S, Hozumi T, Keisuke Sasai, Karasawa Ok
OBJECTIVE This examine aimed to make clear the outcomes of postoperative re-irradiation utilizing stereotactic physique radiotherapy (SBRT) for metastatic epidural spinal wire compression (MESCC) within the authors’ establishment and to determine elements correlated with native management. METHODS Instances wherein sufferers with beforehand irradiated MESCC underwent decompression surgical procedure adopted by backbone SBRT as re-irradiation between April 2013 and Could 2017 had been retrospectively reviewed. The surgical procedures had been primarily carried out by the posterior method and included decompression and fixation. The prescribed dose for backbone SBRT was 24 Gy in 2 fractions. The first consequence was native management, which was outlined as elimination, shrinkage, or no change of the tumor on CT or MRI obtained roughly each three months after SBRT. As well as, varied patient-, treatment-, and tumor-specific elements had been evaluated to find out their predictive worth for native management. RESULTS Twenty-eight instances had been recognized within the authors’ institutional databases as assembly the inclusion standards. The histology of the first illness was thyroid most cancers in 7 instances, lung most cancers in 6, renal most cancers in three, colorectal most cancers in three, and different cancers in 9. The commonest earlier radiation dose was 30 Gy in 10 fractions (15 instances). The imply interval since the newest irradiation was 16 months (vary 5-132 months). The median period of follow-up after SBRT was 13 months (vary Four-38 months). The 1-year native management charge was 70%. Within the evaluation of things associated to native management, Bilsky grade, variety of vertebral ranges within the remedy goal, the interval between the most recent radiotherapy and SBRT, recursive partitioning evaluation (RPA), the prognostic index for spinal metastases (PRISM), and the revised Tokuhashi rating weren’t considerably correlated with native management. The favorable group categorised by the Rades prognostic rating achieved a considerably greater 1-year native management charge than the unfavorable group (1-year native management charge: 100% vs 33%; p < zero.01). Radiation-induced myelopathy and vertebral compression fracture had been noticed in 1 and three sufferers, respectively. No different grade three or larger toxicities had been encountered. CONCLUSIONS The outcomes point out that backbone SBRT as postoperative re-irradiation was efficient, and it was particularly helpful for sufferers categorised as having a great survival prognosis in line with the Rades rating.
PMID: 29905524 [PubMed – as supplied by publisher]