Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy?
Introduction. The choice of treatment between extracranial stereotactic radiotherapy and surgery for metastatic vertebral body tumors with minimum or no epidural compression of the dura mater is yet to be clearly defined. Materials and methods. The study enrolled 41 patients who received treatment a...
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Bashkir State Medical University
2024-07-01
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| Series: | Креативная хирургия и онкология |
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| Online Access: | https://www.surgonco.ru/jour/article/view/948 |
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| author | O. I. Kit D. E. Zakondyrin A. A. Grin E. E. Rostorguev Y. V. Przhedetskiy P. G. Sakun V. I. Voshedskii B. V. Matevosian T. S. Shepelya |
| author_facet | O. I. Kit D. E. Zakondyrin A. A. Grin E. E. Rostorguev Y. V. Przhedetskiy P. G. Sakun V. I. Voshedskii B. V. Matevosian T. S. Shepelya |
| author_sort | O. I. Kit |
| collection | DOAJ |
| description | Introduction. The choice of treatment between extracranial stereotactic radiotherapy and surgery for metastatic vertebral body tumors with minimum or no epidural compression of the dura mater is yet to be clearly defined. Materials and methods. The study enrolled 41 patients who received treatment at the National Medical Research Centre for Oncology (Rostov-on-Don, Russia) from January 1, 2014 to December 31, 2022. The inclusion criterion was the presence of a metastatic vertebral tumor, with minimal or no epidural compression of the dura mater and the radicular infundibulum (ESCC 0–1b). Patients were divided into two groups: 21 patients (SBRT group) received only extracranial stereotactic radiation therapy and 20 patients who underwent surgery followed by adjuvant extracranial stereotactic radiation therapy 1 month after surgery (Op.+Аd.SBRT). Results. The early postoperative period revealed no deterioration in the neurological status of patients in the SBRT group, no improvement in the Karnofsky performance status and no regression of pain syndrome, in contrast to patients in the Op+Аd.SBRT group. In a month after the surgery, tumors continued to grow in 3 patients (21%) of the SBRT group and only in 1 patient (6%) of the Oр.+Аd.SBRT group. Discussion. In the early postoperative period, the Op.+Аd.SBRT group showed an improvement in the functional status and a significantly more pronounced regression of the pain syndrome in the patients of the SBRT group, which can be explained by direct decompression of the compressed spinal root and elimination of increasing instability of the spinal column. Conclusion. Surgical treatment complemented by adjuvant extracranial stereotactic radiation therapy constitutes the preferred treatment for patients with metastatic spinal lesion with minimal epidural spread, without epidural compression of the spinal cord, with severe pain syndrome and signs of increasing instability of the spinal column. |
| format | Article |
| id | doaj-art-a5ac932e5b1840e6b1132fe1afb67081 |
| institution | DOAJ |
| issn | 2076-3093 2307-0501 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Bashkir State Medical University |
| record_format | Article |
| series | Креативная хирургия и онкология |
| spelling | doaj-art-a5ac932e5b1840e6b1132fe1afb670812025-08-20T02:53:30ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012024-07-0114212713510.24060/2076-3093-2024-14-2-127-135571Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy?O. I. Kit0D. E. Zakondyrin1A. A. Grin2E. E. Rostorguev3Y. V. Przhedetskiy4P. G. Sakun5V. I. Voshedskii6B. V. Matevosian7T. S. Shepelya8National Medical Research Centre for Oncology; Rostov State Medical UniversityNational Medical Research Centre for OncologySklifosovsky Institute for Emergency Medicine; Pirogov Russian National Research Medical UniversityNational Medical Research Centre for OncologyNational Medical Research Centre for OncologyNational Medical Research Centre for OncologyNational Medical Research Centre for OncologyNational Medical Research Centre for OncologyRostov State Medical UniversityIntroduction. The choice of treatment between extracranial stereotactic radiotherapy and surgery for metastatic vertebral body tumors with minimum or no epidural compression of the dura mater is yet to be clearly defined. Materials and methods. The study enrolled 41 patients who received treatment at the National Medical Research Centre for Oncology (Rostov-on-Don, Russia) from January 1, 2014 to December 31, 2022. The inclusion criterion was the presence of a metastatic vertebral tumor, with minimal or no epidural compression of the dura mater and the radicular infundibulum (ESCC 0–1b). Patients were divided into two groups: 21 patients (SBRT group) received only extracranial stereotactic radiation therapy and 20 patients who underwent surgery followed by adjuvant extracranial stereotactic radiation therapy 1 month after surgery (Op.+Аd.SBRT). Results. The early postoperative period revealed no deterioration in the neurological status of patients in the SBRT group, no improvement in the Karnofsky performance status and no regression of pain syndrome, in contrast to patients in the Op+Аd.SBRT group. In a month after the surgery, tumors continued to grow in 3 patients (21%) of the SBRT group and only in 1 patient (6%) of the Oр.+Аd.SBRT group. Discussion. In the early postoperative period, the Op.+Аd.SBRT group showed an improvement in the functional status and a significantly more pronounced regression of the pain syndrome in the patients of the SBRT group, which can be explained by direct decompression of the compressed spinal root and elimination of increasing instability of the spinal column. Conclusion. Surgical treatment complemented by adjuvant extracranial stereotactic radiation therapy constitutes the preferred treatment for patients with metastatic spinal lesion with minimal epidural spread, without epidural compression of the spinal cord, with severe pain syndrome and signs of increasing instability of the spinal column.https://www.surgonco.ru/jour/article/view/948neoplasm metastasisspinespine neoplasmsepidural compressionstereotactic radiation therapysurgical treatmentepidural compression |
| spellingShingle | O. I. Kit D. E. Zakondyrin A. A. Grin E. E. Rostorguev Y. V. Przhedetskiy P. G. Sakun V. I. Voshedskii B. V. Matevosian T. S. Shepelya Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? Креативная хирургия и онкология neoplasm metastasis spine spine neoplasms epidural compression stereotactic radiation therapy surgical treatment epidural compression |
| title | Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? |
| title_full | Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? |
| title_fullStr | Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? |
| title_full_unstemmed | Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? |
| title_short | Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy? |
| title_sort | metastatic spinal lesion with minimal epidural compression surgical treatment or stereotactic radiotherapy |
| topic | neoplasm metastasis spine spine neoplasms epidural compression stereotactic radiation therapy surgical treatment epidural compression |
| url | https://www.surgonco.ru/jour/article/view/948 |
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