Early response of breast cancer bone metastases to chemotherapy evaluated with MR imaging

Çiray, I.; Lindman, Henrik; Åström, K.G.O.; Bergh, Jonas; Ahlström, K. H.

doi:10.1080/028418501127346503

Cited by 23 publications

(11 citation statements)

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“…Medical therapies include systemic chemotherapy/hormonal therapy and medications specific for spinal metastases, such as steroids, analgesics, and bisphosphonates [6,12,31,34,41]. Bisphosphonates are highly effective in reducing bone pain, hypercalcemia and pathological fractures, and they are frequently used at our institutions [23,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative irradiation of the operative site was not associated with postoperative wound infection. Instrumentation failure was caused by local and/or distant spinal tumor recurrence in 43% [6] of these patients. Deep wound infections caused instrumentation failure in 21% [3] of these patients, and the remaining five patients (36%) had failure for nonspecific or unclear reasons.…”

Section: Hospital Course and Complicationsmentioning

confidence: 98%

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Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

et al. 2007

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Aggressive surgical management of spinal metastatic disease can provide improvement of neurological function and significant pain relief. However, there is limited literature analyzing such management as is pertains to individual histopathology of the primary tumor, which may be linked to overall prognosis for the patient. In this study, clinical outcomes were reviewed for patients undergoing spinal surgery for metastatic breast cancer. Respective review was done to identify all patients with breast cancer over an eight-year period at a major cancer center and then to select those with symptomatic spinal metastatic disease who underwent spinal surgery. Pre-and postoperative pain levels (visual analog scale [VAS]), analgesic medication usage, and modifed Frankel grade scores were compared on all patients who underwent surgery. Univariate and multivariate analyses were used to assess risks for complications. A total of 16,977 patients were diagnosed with breast cancer, and 479 patients (2.8%) were diagnosed with spinal metastases from breast cancer. Of these patients, 87 patients (18%) underwent 125 spinal surgeries. Of the 76 patients (87%) who were ambulatory preoperatively, the majority (98%) were still ambulatory.Of the 11 patients (13%) who were nonambulatory preoperatively, four patients were alive at 3 months postoperatively, three of which (75%) regained ambulation. The preoperative median VAS of six was significantly reduced to a median score of two at the time of discharge and at 3, 6, and 12 months postoperatively (P < 0.001 for all time points). A total of 39% of patients experienced complications; 87% were early (within 30 days of surgery), and 13% were late. Early major surgical complications were significantly greater when five or more levels were instrumented. In patients with spinal metastases specifically from breast cancer, aggressive surgical management provides significant pain relief and preservation or improvement of neurological function with an acceptably low rate of complications.

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Section: Discussionmentioning

confidence: 99%

Section: Hospital Course and Complicationsmentioning

confidence: 98%

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

et al. 2007

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“…A multidisciplinary approach including medical treatment, radiotherapy, and/or surgery is the ideal treatment of breast metastasis [3,32]. Medical therapies include systemic chemotherapy/hormonal therapy and medications specific for spinal metastases, such as steroids, analgesics, and bisphosphonates [7,13,30,32,43]. For patients with localized bone pain that has not responded to systemic therapy and analgesics, external beam irradiation (30 Gy in ten fractions) has traditionally been the treatment of choice and usually provides good pain relief [29][30][31]42].…”

Section: Discussionmentioning

confidence: 99%

Positive and negative prognostic variables for patients undergoing spine surgery for metastatic breast disease

et al. 2007

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The histology of the primary tumor in metastatic spine disease plays an important role in its treatment and prognosis. However, there is paucity in the literature of histology-specific analysis of spinal metastases. In this study, prognostic variables were reviewed for patients who underwent surgery for breast metastases to the spinal column. Respective chart review was done to first identify all patients with breast cancer over an 8-year period at a major cancer center and then to select all those with symptomatic metastatic disease to the spine who underwent spinal surgery. Univariate and multivariate analyses were used to assess several prognostic variables. Presence of visceral metastases, multiplicity of bony lesions, presence of estrogen receptors (ER), and segment of spine (cervical, thoracic, lumbar, sacral) in which metastases arose were compared with patient survival. Eighty-seven patients underwent 125 spinal surgeries. Those with estrogen receptor (ER) positivity had a longer median survival after surgery compared to those with estrogen receptor negativity. Patients with cervical location of metastasis had a shorter median survival compared with those having metastases in other areas of the spine. The presence of visceral metastases or a multiplicity of bony lesions did not have prognostic value. In patients with spinal metastases from breast cancer, aggressive surgical management may be an option for providing significant pain relief and preservation/improvement of neurological function. Interestingly, in patients undergoing such surgery, cervical location of metastasis is a negative prognostic variable, and ER-positivity is associated with better survival, while presence of visceral or multiple bony lesions does not significantly alter survival.

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“…These tools are mainly based on the follow-up of lesion size, and they use several response categories (progressive disease, complete response, partial response, stable disease) (RECIST). The evaluation of tumor burden provided by these various measurement tools and its follow-up during therapy show promising correlation with other imaging (soft tissue metastasis quantification) indices of tumor response to therapy and with the clinical and follow-up evaluation of treatment response in breast, prostate and other cancers (Brown et al 1998;Ciray et al 2001;Tombal et al 2005). This offers the perspective to increase the number of patients (i.e.…”

Section: Quantitative Criteriamentioning

confidence: 97%

MRI for Response Assessment In Oncologic Bone Marrow Lesions

Lecouvet

Omoumi

Larbi

et al. 2013

Magnetic Resonance Imaging of the Bone Marrow

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Early response of breast cancer bone metastases to chemotherapy evaluated with MR imaging

Abstract: The long TE IR-TSE sequence demonstrated early partial response of breast cancer bone metastases to chemotherapy more accurately than the T1-weighted sequence.

Cited by 23 publications

References 0 publications

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

Positive and negative prognostic variables for patients undergoing spine surgery for metastatic breast disease

MRI for Response Assessment In Oncologic Bone Marrow Lesions

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