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radiation spinal cord compression

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https://www.readbyqxmd.com/read/28297335/on-the-accuracy-of-dose-prediction-near-metal-fixation-devices-for-spine-sbrt
#1
Zhangkai J Cheng, Regina M Bromley, Brad Oborn, Martin Carolan, Jeremy T Booth
The metallic fixations used in surgical procedures to support the spine mechanically usually consist of high-density materials. Radiation therapy to palliate spinal cord compression can include prophylactic inclusion of potential tumor around the site of such fixation devices. Determination of the correct density and shape of the spine fixation device has a direct effect on the dose calculation of the radiation field. Even with the application of modern computed tomography (CT), under- or overestimation of dose, both immediately next to the device and in the surrounding tissues, can occur due to inaccuracies in the dose prediction algorithm...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28274397/results-of-a-multicenter-study-investigating-the-potential-impact-of-the-overall-treatment-time-on-outcomes-of-radiation-therapy-alone-with-5%C3%A3-4-gy-for-metastatic-epidural-spinal-cord-compression
#2
Dirk Rades, Theo Veninga, Antonio J Conde-Moreno, Jon Cacicedo, Michaela Metz, Barbara Šegedin, Darius Norkus, Volker Rudat, Steven E Schild
PURPOSE/OBJECTIVE: A 5×4 Gy program is commonly used for metastatic epidural spinal cord compression (MESCC). It is unclear whether an overall treatment time (OTT) of 5 days (5 consecutive fractions) results in better outcomes than an OTT of 7 days (ie, no irradiation during the weekend). METHODS AND MATERIALS: A total of 111 patients who received 5×4 Gy over 5 consecutive days were retrospectively compared with 277 patients treated with 5×4 Gy over 7 days (no irradiation during the weekend) for effect on motor function, local control of MESCC, and overall survival (OS)...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28237218/stereotactic-ablative-body-radiotherapy-for-the-treatment-of-spinal-oligometastases
#3
J H Chang, S Gandhidasan, R Finnigan, D Whalley, R Nair, A Herschtal, T Eade, A Kneebone, J Ruben, M Foote, S Siva
AIMS: To report multicentre outcomes of patients with spinal oligometastases treated with stereotactic ablative body radiotherapy (SABR). The primary objective was to estimate the widespread failure-free survival (WFFS) at 2 years - defined as freedom from metastases not amenable to local salvage therapy and death. MATERIALS AND METHODS: Patients with one to three metastases treated with spinal SABR between January 2010 and July 2014 at four academic institutions were included in this retrospective review...
February 22, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28220804/impact-of-symptomatic-skeletal-events-on-health-care-resource-utilization-and-quality-of-life-among-patients-with-castration-resistant-prostate-cancer-and-bone-metastases
#4
R McKay, B Haider, M S Duh, A Valderrama, M Nakabayashi, M Fiorillo, L Ristovska, L Wen, P Kantoff
BACKGROUND: Data regarding the impact of symptomatic skeletal events (SSEs) on health economics and patient-reported outcomes in men with castration-resistant prostate cancer (CRPC) and bone metastases from a clinical setting are lacking. Hence, this study aimed to quantify the effects of SSEs on health-care resource utilization (HRU), health-related quality of life (HRQoL) and pain in men with CRPC metastasized to bone. METHODS: This cohort study included men with CRPC and bone metastasis treated at a tertiary center during December 1996-July 2015...
February 21, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#5
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28181815/onsite-versus-offsite-radiation-treatment-of-malignant-spinal-cord-compression-lessons-from-a-safety-net-health-system
#6
Albert C Chen, Mark D Bonnen, Henry Mok
OBJECTIVE: Metastatic spinal cord compression (MSCC) is an oncologic emergency that often warrants emergent treatment; but, it is unclear whether radiation treatment (RT) can be optimally managed from an offsite radiotherapy facility. METHODS: Patient charts from consecutive patients with MSCC who were treated with radiotherapy alone at either an onsite hospital radiation department (from 2008 to 2012) or an offsite radiotherapy centre (2012-2015) were reviewed...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28156606/role-of-emergent-palliative-radiation-therapy-in-the-care-of-patients-with-cancer
#7
Michael Zhang, Steve E Braunstein, Shannon E Fogh
201 Background: Radiation therapy (RT) provides an important role in the palliative care of patients with cancer. For patients with metastatic spinal cord compression not amenable to surgery, the value of timely palliative RT is well established; however, the value of the rapid application of RT for other chief complaints is less clear. The importance of palliative care service (PCS) involvement in patients treated with RT is becoming increasingly recognized and rapidly instituted RT could compromise this involvement...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28138012/early-intervention-results-in-lower-mortality-in-patients-with-cancer-hospitalized-for-metastatic-spinal-cord-compression
#8
Achuta Kumar Guddati, Gagan Kumar, Iuliana Shapira
Metastatic spinal cord compression (MSCC) is one of the most dreaded complications of cancer. A Nationwide Inpatient Sample (NIS) from 2000 to 2011 was used to extract data for all in-hospital stays of patients with MSCC using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. The usage and timing of radiation therapy and surgical interventions were identified using ICD-9-M codes. These interventions were defined as 'early intervention' if they were provided within the first 48 hours of hospitalization...
January 30, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28125937/thoracic-compression-myelopathy-due-to-the-progression-of-dystrophic-scoliosis-the-presence-of-a-paraspinal-tumor-and-high-and-excessive-amplitude-movement-of-the-shoulder
#9
Takashi Kurosawa, Takashi Yurube, Kenichiro Kakutani, Koichiro Maeno, Koki Uno, Masahiro Kurosaka, Kotaro Nishida
The authors present a case of 45-year-old man with neurofibromatosis type 1 (NF-1) and thoracic scoliosis, previously undergoing fusion surgery, who developed myelopathy. This patient further complained of lightning pain when he extended and horizontally abducted the convex-side shoulder. Radiological examination revealed the progression of dystrophic scoliosis with opened spinal canals and the presence of a neurofibroma behind the spinal cord at the apical levels. Delayed development of spinal instability can occur due to dystrophy even postoperatively in patients with NF-1...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28045115/skeletal-related-events-significantly-impact-health-related-quality-of-life-in-metastatic-castration-resistant-prostate-cancer-data-from-prevail-and-affirm-trials
#10
F Saad, C Ivanescu, D Phung, Y Loriot, S Abhyankar, T M Beer, B Tombal, S Holmstrom
BACKGROUND: We investigated the impact of skeletal-related events (SREs) on health-related quality of life (HRQoL) in patients with metastatic castration-resistant prostate cancer (mCRPC) in phase III trials of enzalutamide versus placebo. METHODS: Patients with mCRPC experiencing at least one SRE during AFFIRM and PREVAIL were assessed for trajectory-adjusted mean change in HRQoL by first SRE using Functional Assessment of Cancer Therapy-Prostate (FACT-P; AFFIRM, three domains, and PREVAIL, nine domains) and EQ-5D (PREVAIL) instruments...
March 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28044212/skeletal-related-events-and-prognosis-in-urothelial-cancer-patients-with-bone-metastasis
#11
Yusuke Tsuda, Tohru Nakagawa, Yusuke Shinoda, Atsushi Kanatani, Taketo Kawai, Satoru Taguchi, Yukio Yamada, Ryoko Sawada, Haruki Kume, Yukio Homma, Sakae Tanaka, Hirotaka Kawano
BACKGROUND: The aim of the present study was to elucidate the details of bone metastasis (BM) and the resulting skeletal-related events (SREs), and survival and prognostic factors, in urothelial cancer (UC) patients with BM. METHODS: A total of 48 UC patients with BM who were treated at our institution between 1994 and 2013 were enrolled. Details of BM and SREs were investigated. The Kaplan-Meier method was used to estimate survival duration. Relationships between several clinical features and survival were analyzed using the log-rank test and the Cox hazard model...
January 2, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#12
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041319/rapid-and-complete-radiological-resolution-of-an-intradural-cervical-cord-lung-cancer-metastasis-treated-with-spinal-stereotactic-radiosurgery-case-report
#13
E Emily Bennett, Camille Berriochoa, Ghaith Habboub, Scott Brigeman, Samuel T Chao, Lilyana Angelov
Stereotactic radiosurgery (SRS) has emerged as a treatment option for patients with spinal metastatic disease. Although SRS has been shown to be successful in a multitude of extradural metastatic tumors causing cord compression, very few cases of intradural treatment have been reported. The authors present a rare case of an intradural extramedullary metastatic small cell lung cancer lesion to the cervical spine resulting in cord compression in an area that had also been extensively pretreated with conventional external-beam radiation therapy...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041314/spinal-stereotactic-body-radiotherapy-following-intralesional-curettage-with-separation-surgery-for-initial-or-salvage-chordoma-treatment
#14
Dennis T Lockney, Timothy Shub, Benjamin Hopkins, Natalie A Lockney, Nelson Moussazadeh, Eric Lis, Yoshiya Yamada, Adam M Schmitt, Daniel S Higginson, Ilya Laufer, Mark Bilsky
OBJECTIVE Chordoma is a rare malignant tumor for which en bloc resection with wide margins is advocated as primary treatment. Unfortunately, due to anatomical constraints, en bloc resection to achieve wide or marginal margins is not feasible for many patients as the resulting morbidity would be prohibitive. The objective of this study was to evaluate the efficacy of intralesional curettage and separation surgery followed by spinal stereotactic body radiation therapy (SBRT) in patients with chordomas in the mobile spine...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28030702/effect-of-longer-interval-vs-standard-dosing-of-zoledronic-acid-on-skeletal-events-in-patients-with-bone-metastases-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Andrew L Himelstein, Jared C Foster, James L Khatcheressian, John D Roberts, Drew K Seisler, Paul J Novotny, Rui Qin, Ronald S Go, Stephen S Grubbs, Tracey O'Connor, Mario R Velasco, Douglas Weckstein, Ann O'Mara, Charles L Loprinzi, Charles L Shapiro
Importance: Zoledronic acid, a third-generation aminobisphosphonate, reduces the incidence of skeletal-related events and pain in patients with bone metastases. The optimal dosing interval for zoledronic acid is uncertain. Objective: To determine whether zoledronic acid administered every 12 weeks is noninferior to zoledronic acid administered every 4 weeks. Design, Setting, Participants: Randomized, open-label clinical trial conducted at 269 academic and community sites in the United States...
January 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28026861/diagnosis-and-treatment-of-epidural-metastases
#16
REVIEW
M Loreto Yáñez, Julie J Miller, Tracy T Batchelor
Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Moreover, current treatment paradigms are reviewed. The timely initiation of radiation as well as surgery in select cases is critical for preserving neurological function and achieving local tumor control and pain control...
April 1, 2017: Cancer
https://www.readbyqxmd.com/read/28008381/pathologic-fracture-and-healthcare-resource-utilisation-a-retrospective-study-in-eight-european-countries
#17
Jean-Jacques Body, Yves Pascal Acklin, Oliver Gunther, Guy Hechmati, João Pereira, Nikos Maniadakis, Evangelos Terpos, Jindrich Finek, Roger von Moos, Susan Talbot, Harm Sleeboom
BACKGROUND: Skeletal-related events (SREs; pathologic fracture [PF], spinal cord compression and radiation or surgery to bone) are common complications of bone metastases or bone lesions and can impose a considerable burden on patients and healthcare systems. In this study, the healthcare resource utilisation (HRU) associated with PFs in patients with bone metastases or lesions secondary to solid tumours or multiple myeloma was estimated in eight European countries. METHODS: Eligible patients were identified in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland...
November 2016: Journal of Bone Oncology
https://www.readbyqxmd.com/read/27968857/surgical-treatment-of-patients-with-lung-cancer-and-bone-metastases-a-prospective-observational-study
#18
Wang Zhiyu, Zhang Rui, Wang Shuai, Zhao Hui
BACKGROUND: As life expectancy improves in patients with lung cancer and bone metastases, effective surgical treatment to relieve pain and improve quality of life and neurological function is increasingly needed. Indications for surgery in patients with bone metastases are controversial. We aimed to assess a protocol for the surgery of patients with lung cancer and bone metastases. METHODS: We developed a surgical protocol for both spinal and appendicular metastases...
October 2016: Lancet
https://www.readbyqxmd.com/read/27912991/malignant-spinal-cord-compression-adapting-conventional-rehabilitation-approaches
#19
REVIEW
Lisa Marie Ruppert
Spinal tumors are classically grouped into 3 categories: extradural, intradural extramedullary, and intradural intramedullary. Spinal tumors may cause spinal cord compression and vascular compromise resulting in pain or neurologic compromise. They may also alter the architecture of the spinal column, resulting in spinal instability. Oncologic management of spinal tumors varies according to the stability of the spine, neurologic status, and presence of pain. Treatment options include surgical intervention, radiation therapy, chemotherapy, and hormonal manipulation...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27896639/seom-clinical-guideline-for-bone-metastases-from-solid-tumours-2016
#20
C Grávalos, C Rodríguez, A Sabino, M Á Seguí, J A Virizuela, A Carmona, J Cassinello, D Isla, C Jara, M Martín
Bone metastases are common in many advanced solid tumours, being breast, prostate, thyroid, lung, and renal cancer the most prevalent. Bone metastases can produce skeletal-related events (SREs), defined as pathological fracture, spinal cord compression, need of bone irradiation or need of bone surgery, and hypercalcaemia. Patients with bone metastases experience pain, functional impairment and have a negative impact on their quality of life. Several imaging techniques are available for diagnosis of this disease...
December 2016: Clinical & Translational Oncology
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