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Radiotherapy or surgery for spine metastases?
Olga Zaikova1, Sophie D Fosså, Oyvind S Bruland
1Department of Orthopaedics, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. olga.zaikova@oslo-universitetssykehus.no
Acta Orthopaedica
|March 26, 2011
Summary
Surgery was primarily indicated for spine metastases (SM) patients with motor impairment. Better identification of patients with short survival is needed to optimize treatment selection between surgery and radiotherapy (RT).
Area of Science:
- Oncology
- Neurosurgery
- Radiation Oncology
Background:
- Radiotherapy (RT) is standard for spine metastases (SM), but surgery is used for select cases.
- Understanding treatment patterns and outcomes is crucial for optimizing SM management.
Purpose of the Study:
- Compare RT and surgery for SM in a population-based cohort.
- Identify pre-treatment factors influencing treatment choice.
- Examine survival outcomes for RT and surgery.
Main Methods:
- Retrospective review of 903 patients with first-time RT or surgery for SM.
- Data collected over an 18-month period (2007-2008) in South-Eastern Norway.
Main Results:
- Surgery was primary treatment for 58 patients; RT for 845 (704 MF-RT, 141 SF-RT).
- Motor impairment significantly increased likelihood of primary surgery (17% vs 2%).
- 2-month mortality was 2% for operated patients and 29% for irradiated patients.
Conclusions:
- Motor impairment is the primary driver for surgical intervention in SM.
- Improved patient selection, especially for those with short survival, is necessary to avoid lengthy treatments like major surgery and long-term RT.