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Radiotherapy or surgery for spine metastases?

BACKGROUND AND PURPOSE: Radiotherapy (RT) remains the cornerstone of management of spine metastases (SM), even though surgery is a well-established treatment for selected patients. We compared the use of RT and surgery in a population-based cohort of patients with SM, investigated pre-treatment factors that were associated with use of these treatment modalities, and examined survival. PATIENTS AND METHODS: 903 patients in the south-eastern Norway who were admitted for RT or surgery for SM for the first time during an 18-month period in 2007-2008 were identified and their medical records were reviewed. RESULTS: The primary treatment was surgery in 58 patients and RT in 845 patients, including 704 multiple-fraction (MF) and 141 single-fraction (SF) RT schedules. 11 of 607 patients without motor impairment (2%) and 47 of 274 patients with motor impairment (17%) underwent primary operations. 11 of 58 operated patients and 244 of 845 irradiated patients died within 2 months after the start of treatment. 26% of those who received multiple-fraction RT or surgery died within 2 months. INTERPRETATION: Motor impairment was the main indication for surgery. Better identification of patients with short survival is needed to avoid time-consuming treatment (major surgery and long-term RT)

Keywords : Adult,Aged,Aged,80 and over,Cohort Studies,epidemiology,etiology,Female,Humans,Male,Medical Records,methods,Middle Aged,mortality,Motor Activity,Norway,Patient Selection,radiotherapy,Retrospective Studies,secondary,Spinal Cord Compression,Spinal Neoplasms,Spine,surgery,Survival Analysis,therapy,Treatment Outcome,Young Adult,, Or,Surgery,Spine,Metastases?, headache specialist london

Date of Publication : 2011 Jun

Authors : Zaikova O;Fossa SD;Bruland OS;Giercksky KE;Sandstad B;Skjeldal S;

Organisation : Department of Orthopaedics, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. [email protected]

Journal of Publication : Acta Orthop

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21434789

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