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radiation spinal cord compression

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https://www.readbyqxmd.com/read/28437208/considerations-for-quality-improvement-in-radiation-oncology-therapy-for-patients-with-uncomplicated-painful-bone-metastases
#1
Anne M Walling, Phillip J Beron, Tania Kaprealian, Patrick A Kupelian, Neil S Wenger, Susan A McCloskey, Christopher R King, Michael Steinberg
BACKGROUND: There is an increasing need for evidence-based efficiency in providing a growing amount of cancer care. One example of a quality gap is the use of multiple-fraction palliative radiation for patients with advanced cancer who have uncomplicated bone metastases; evidence suggests similar pain outcomes for treatment regimens with a lower burden of treatments. METHODS: During the first phase of quality improvement work, we used RAND/UCLA appropriateness methodology to understand how radiation oncologists at one academic medical center rate the appropriateness of different treatment regimens for painful uncomplicated bone metastases...
February 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#2
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28407704/delayed-epidural-mucin-collection-after-surgery-for-spinal-metastatic-pancreatic-adenocarcinoma
#3
Dong Ha Kim, Dong Hwan Kim, Hwan Soo Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
A rare case of delayed large epidural mucin collection causing neurologic deficit after surgery for metastatic pancreatic cancer is reported. A 65-year-old man presented with intractable upper-thoracic back pain radiating to the chest and gait disturbance. He had a history of subtotal pancreatectomy due to intraductal papillary mucinous neoplasm (IPMN) of the pancreas and concurrent chemotherapy. Eight months after pancreatectomy, multiple thoracic spinal metastasis was diagnosed with routine up positron emission tomography-computed tomography...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28404935/outcomes-of-metastatic-spinal-cord-compression-secondary-to-primary-hepatocellular-carcinoma-with-multidisciplinary-treatments
#4
Shaohui He, Haifeng Wei, Yifei Ma, Jian Zhao, Wei Xu, Jianru Xiao
Few studies have reported progression-free survival (PFS) and overall survival (OS) of Metastatic spinal cord compression (MSCC) patients with primary hepatocellular carcinoma (HCC) following surgery and adjuvant therapies. Enrolled in this study were 155 MSCC patients with primary HCC who received surgery and adjuvant therapies between 2000 and 2015. Kaplan-Meier methods and Cox's proportional hazards regression mode were performed to investigate the clinical features and prognostic factors affecting PFS and OS...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#5
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28393590/feasibility-of-extended-dosing-intervals-of-denosumab
#6
Jacob K Kettle, Puja B Patel
Purpose Denosumab is a crucial supportive care agent for patients with advanced cancers affecting the bone. Despite the importance of treatment, logistical and financial obstacles hinder the ability to maintain long-term adherence. This analysis was designed to provide preliminary data regarding the feasibility of extended denosumab dosing intervals. Methods This retrospective, case cohort study was conducted on patients receiving treatment with denosumab for malignancies with bone involvement. A total of 60 patients were identified for analysis and were divided into cohorts according to the average number of days between denosumab doses...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28376922/epidemiological-characteristics-of-primary-spinal-osseous-tumors-in-eastern-china
#7
Zhenhua Zhou, Xudong Wang, Zhipeng Wu, Wending Huang, Jianru Xiao
BACKGROUND: Primary spinal osseous tumors are rare, yet they represent a difficult treatment paradigm because of the complexities of tumor resection and significant resistance to chemotherapy and radiation therapy. The geographic distribution of primary spinal osseous tumors throughout the world appears to be quite variable, with a very low incidence reported in Asian countries. METHODS: Data on 1209 cases of primary spinal osseous malignant and benign tumor cases diagnosed during the 20-year period of 1995 through 2015 in eastern China were analyzed...
April 4, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28297335/on-the-accuracy-of-dose-prediction-near-metal-fixation-devices-for-spine-sbrt
#8
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
#9
MULTICENTER STUDY
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
#10
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
#11
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
#12
REVIEW
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
#13
COMPARATIVE STUDY
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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