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The Feasibility of Spinal Stereotactic Radiosurgery for Spinal Metastasis with Epidural Cord Compression

Title
The Feasibility of Spinal Stereotactic Radiosurgery for Spinal Metastasis with Epidural Cord Compression
Authors
Kim, Yi-JunKim, Jin HoKim, KyuboKim, Hak JaeChie, Eui KyuShin, Kyung HwanWu, Hong-GyunKim, Ii Han
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2019
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
1598-2998JCR Link

2005-9256JCR Link
Citation
CANCER RESEARCH AND TREATMENT vol. 51, no. 4, pp. 1324 - 1335
Keywords
SpineNeoplasm metastasisSpinal cord compressionFracturesCompressionRadiosurgeryDisease progression
Publisher
KOREAN CANCER ASSOCIATION
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Purpose The purpose of this study was to investigate the effectiveness and safety of spinal stereotactic radiosurgery (SRS) in treating spinal metastasis with epidural spinal cord compression (ESCC). Materials and Methods During 2013-2016, 149 regions of spinal metastasis in 105 patients treated with single-fraction (12-24 Gy) spinal SRS were reviewed. Cord compression of Bilsky grade 2 (with visible cerebrospinal fluid [CSF]) or 3 (no visible CSF) was defined as ESCC. Local progression (LP) and vertebral compression fracture (VCF) rates after SRS were evaluated using multivariate competing-risk regression analysis. Results The 1-year cumulative incidences of LP for Bilsky grades 0 (n=80), 1 (n=39), 2 (n=21), and 3 (n=9) were 3.0%, 8.4%, 0%, and 24.9%, respectively. Bilsky grade 2 ESCC did not significantly increase the LP rate (no LP for grade 2). The 1-year cumulative incidences of VCF for Bilsky grades 0, 1, 2, and 3 were 6.6%, 5.2%, 17.1%, and 12.1%, respectively. ESCC may increase VCF risk (subhazard ratio [SHR] for grade 2, 5.368; p=0.035; SHR for grade 3, 2.215; p=0.460). Complete or partial pain response rates after SRS were 79%, 78%, 53%, and 63% for Bilsky grades 0, 1, 2, and 3, respectively (p=0.008). No neurotoxicity of grade >= 3 was observed. Conclusion Spinal SRS for spinal metastasis with Bilsky grade 2 ESCC did not increase the LP rate, was not associated with severe neurotoxicity, and showed moderate VCF and pain response rates. Bilsky grade 3 had a high LP rate.
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DOI
10.4143/crt.2018.653
Appears in Collections:
의과대학 > 의학과 > Journal papers
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