Survival, local control, and health‐related quality of life in patients with oligometastatic and polymetastatic spinal tumors: A multicenter, international study

Barzilai, Ori; Versteeg, Anne; Sahgal, Arjun; Rhines, Laurence D.; Bilsky, Mark H.; Sciubba, Daniel M.; Schuster, James M.; Weber, Michael H.; Varga, Péter Pál; Boriani, Stefano; Bettegowda, Chetan; Fehlings, Michael G.; Yamada, Yoshiya; Clarke, Michelle J.; Arnold, Paul M.; Gokaslan, Ziya L.; Fisher, Charles G.; Laufer, Ilya

doi:10.1002/cncr.31870

Cited by 44 publications

(30 citation statements)

References 30 publications

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“…Specific to spine oligometastases, Barzilai et al reported results from the AO Spine multicenter prospective cohort Epidemiology, Process, and Outcomes of Spine Oncology (EPOSO) study (30). Patients with oligometastatic disease (defined as <5 metastases) showed evidence of better survival compared to those with polymetastatic disease (>5 metastases).…”

Section: Spine Metastases and Sbrtmentioning

confidence: 99%

Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview

et al. 2019

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The oligometastatic state is hypothesized to represent an intermediary state of cancer between widely metastatic disease and curable, localized disease. Advancements in radiotherapy have allowed for delivery of high precision, dose escalated treatment known as stereotactic body radiotherapy (SBRT) to targets throughout the body with excellent rates of local control. Recently, the first phase II randomized trial comparing conventional radiotherapy to comprehensive SBRT of oligometastatic disease demonstrated an overall survival and progression free survival advantage. The spine is a common site of metastasis, and a complex site for SBRT given the adjacent spinal cord and the tumor embedded within the bone tissue putting the patient at risk of fracture. Although there are expert spine SBRT guidelines for practice, there are as yet no reported randomized trials that proves superiority as compared to conventional radiation. The use of SBRT in patients with oligometastatic disease and spinal metastases is the focus of this review.

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Section: Spine Metastases and Sbrtmentioning

confidence: 99%

Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview

et al. 2019

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“…He compared the 1-year Local Control rate of each of the treatments. It was found that surgery with or without RT (n=129) had 65.5% 1-year local control, cEBRT (n=23) had 57.1% 1-year local control rate and SRS (n=63) had 84.8% 1 year local control rate [9]. The Kaplan Meier Curves further supporting this evidence can be found in Appendix A.…”

Section: Introductionmentioning

confidence: 60%

“…Some studies included comparison with polymetastatic disease of spine and compared outcomes, this was excluded when analyzing Kaplan Meier Curves or data tables. Only statistically significant data was chosen to make valid comparisons between Local Control or Overall Survival rates [7][8][9][10][11][12][13][14][15][16][17][18] .…”

Section: Methodsmentioning

confidence: 99%

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Comparison of the Effectiveness of Stereotactic Radiosurgery for Spinal Oligometastatic Disease With Surgical and Conventional External Beam Radiotherapy Determined by Local Control, Overall Survival, Pain Response and Toxicities: A Systematic Review.

Saha¹,

Hamdan²,

Ajayi³

et al. 2020

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The aim of this study is to determine whether there is a benefit of using stereotactic radiosurgery (SRS) versus surgery or conventional external beam radiotherapy (cEBRT) for spinal oligometastatic disease in terms of tumor control, pain control, toxicity and morbidity. This systematic review was conducted by searching electronic databases such as Pubmed, Medline (Ovid) and Oxford Academic using an adapted version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) checklist. Retrospective and prospective studies were identified and investigated for methods of treatment such as SRS, surgery and radiotherapy of spinal oligometastatic disease. Local Control rates, Overall Survival (OS) rates, Pain Response (PR) and toxicities were extracted to be investigated and compared. A study eligibility criterion was made to ensure that results were valid, statistically significant and relevant to the investigation. One hundred and five articles were relevant to oligometastatic disease with the mention of spinal metastases however 89 of these articles were excluded based on irrelevance to investigation, title, abstract and duplication. Sixteen full text articles were thoroughly screened including 9 of them in the review. For 601 patients the average one year local control rate was 89%, average one year overall survival rate was 88%, evidence of pain relief was present, and some patients suffered low grade toxicities. In conclusion, stereotactic radiosurgery is an excellent modality of treatment of spinal oligometastatic disease as local control rates, overall survival rates, pain response and toxicities indicate improved outcomes in comparison to studies that investigated the same factors with the treatment of surgery or cEBRT. However, there is a lack of data here to make statistically valid claims and require more studies & data to be analyzed and compared.

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“…2 The oligometastatic state is commonly defined as 5 or fewer metastatic sites systemically. 3 In the spine, bony metastases can cause complications such as severe pain, neurological compromise, and mechanical instability leading to vertebral compression fracture (VCF). 4 Hence, one of the primary goals of care for spine metastases is longterm tumour control with ablative therapy.…”

Section: Introductionmentioning

confidence: 99%

Vertebral fractures following stereotactic body radiotherapy for spine metastases

et al. 2020

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Stereotactic body radiotherapy has emerged as one of the preferred treatments for patients with spine metastases, with the potential for long-term control from lesion irradiation. Post-treatment vertebral compression fractures are a known complication of this therapy, contributing to worsening pain and reduced quality of life, sometimes requiring surgical intervention. This review explores the current knowledge of post-radiotherapy fractures, in terms of the rates and associated predictive factors. A search of databases including Medline, Embase and the Cochrane Library was conducted using keywords such as 'vertebral compression fracture', 'stereotactic body radiotherapy' and 'spine metastases'. The search was limited to published studies up to March 2019, reporting clinical outcomes including both the post-treatment fracture rate and statistical identification of associated risk factors. Rates of post-treatment fractures ranged from 4 to 39%. A variety of factors were found to increase the risk, including the appearance of lytic vertebral disease, degree of pre-existing compression, spinal malalignment, increased dose per fraction and a Spinal Instability Neoplastic Score >6. This knowledge can enable clinicians to counsel patients when considering management options for spine metastases, maintaining the balance between local tumour control and the risk of subsequent fracture.

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Survival, local control, and health‐related quality of life in patients with oligometastatic and polymetastatic spinal tumors: A multicenter, international study

Abstract: the AO Spine Knowledge Forum Tumor 17

Cited by 44 publications

References 30 publications

Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview

Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview

Comparison of the Effectiveness of Stereotactic Radiosurgery for Spinal Oligometastatic Disease With Surgical and Conventional External Beam Radiotherapy Determined by Local Control, Overall Survival, Pain Response and Toxicities: A Systematic Review.

Vertebral fractures following stereotactic body radiotherapy for spine metastases

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