We reviewed records of 79 men with spinal epidural metastases diagnosed from July 1984 to July 1989, imaged by myelography or MRI, and treated with radiation therapy. Thirteen men (16%) had second epidural metastases. The mean time between lesions that developed within two vertebral bodies of a prior lesion was 2.8 months, compared with 15.2 months for lesions that were three or more vertebral bodies from a prior lesion. Some secondary spinal metastases occurring soon after the initial metastasis may represent regrowth of tumor at the border of the radiation port, suggesting that larger radiation ports be constructed for patients with lengthy expected survival times.
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http://dx.doi.org/10.1212/wnl.41.5.744 | DOI Listing |
Am J Clin Oncol
January 2025
Department of Radiation Oncology, University of Michigan.
Objectives: To determine if piecemeal separation surgery, in conjunction with smaller treatment volumes utilized with spine stereotactic radiation therapy (S-SBRT), increased the risk of adjacent level progression (ALP).
Methods: We performed a retrospective analysis of a prospectively maintained database of adult spine oncologic patients who underwent SBRT to the spine at University of Michigan from 2010 to 2021. We compared ALP in patients undergoing SBRT who had pretreatment surgery with those who did not.
Cancers (Basel)
December 2024
Department of Neurosurgery, University of Marburg, 35037 Marburg, Germany.
Background: The aim of this study was to assess the surgical outcomes and survival of patients surgically treated for metastatic epidural spinal cord compression (MESCC), with a specific focus on identifying factors that influence overall survival and readmission-free survival.
Methods: All patients who underwent surgery for spine metastases at our department in the period 2018-2022 were included in the study.
Results: A total of 175 patients (n = 71 females, median age 67.
JAMA Oncol
December 2024
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Importance: Stereotactic body radiation therapy (SBRT) for spinal metastases improves symptomatic outcomes and local control compared to conventional radiotherapy. Treatment failure most often occurs within the epidural space, where dose is constrained by the risk of radiation myelitis (RM). Current constraints designed to prevent RM after spine SBRT are derived from limited data.
View Article and Find Full Text PDFJA Clin Rep
December 2024
Division of Operation Room, Nagoya University Hospital, Nagoya, Aichi, Japan.
Background: Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved voiding function.
Case Presentation: A 45-year-old woman with multiple metastases of malignant pheochromocytoma suffered severe anal pain that worsened, especially when sitting, and was unresponsive to opioid rescue therapy.
Cureus
October 2024
Department of Neurosurgery, Military Medical Academy, Sofia, BGR.
Percutaneous vertebroplasty (PVP) is a minimally invasive procedure that allows for treating or preventing vertebral fractures resulting from trauma, osteoporosis, or oncological conditions. Metastatic spinal disease is a condition that necessitates mostly palliative care and pain management with minimal invasiveness. It could present with axial or localized back pain and may be associated with neurological deficit if compression of the spinal cord and/or the nerve roots is involved.
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