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Image-guided radiosurgery
for single spinal metastasis
S. Ryu, J. Rock, F.-F. Yin, M. Ajlouni, M. Rosenblum, J. H. Kim
Henry Ford Hospital, Detroit, MI
Background.
The precision and accuracy of image-guided spinal
radiosurgery has been previously demonstrated.
We have extended on the spinal radiosurgery to treat a
single spinal metastasis.
This study was carried out to determine the clinical
efficacy of spinal radiosurgery for treatment of spinal metastases with or
without cord compression.
Methods.
A total of 49 patients with 61 lesions of spinal metastasis were
treated with radiosurgery at Henry Ford Hospital from May 2001 to May
2003.
All patients had pathologically-proven primary cancers and
had either synchronous or metachronous metastases to the spine.
The majority of the patients had back pain as the
presenting symptom and 17 lesions were associated with neurologic signs.
The involved spine was treated with single dose
radiosurgery.
The range of radiation dose was 10 –16 Gy in 2 Gy
increments.
The entire radiosurgery procedure was performed on an
out-patient basis.
Endpoints of analysis were pain control, neurologic
improvement, and radiologic tumor control.
Results.
The median time to pain relief was 14 days and the earliest time
of pain relief was within 24 hours.
The median duration of pain relief was 13.3 months.
Complete and partial pain relief was achieved in 37.7 %
and 47.6% of the lesions treated, respectively.
Relapse of pain at the treated site was noted in
6.9%.
Neurologic improvement and radiologic tumor control were
noted in patients with cord compression by epidural soft tissue mass.
Progressive metastasis in the adjacent spines was seen
only in 4.9%.
There was no acute or subacute radiation toxicity detected
clinically during the maximum follow up of 24 months.
Conclusions.
A large single dose spinal radiosurgery achieves a rapid and
durable pain relief as well as radiological tumor control and neurologic
improvement.
Tumor progression to the immediately adjacent spine was
rare.
The results support the use of single dose spinal
radiosurgery as an effective treatment option for single spinal metastasis with
or without spinal cord compression.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-001268,00.asp
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