Fifty-year history of the evolution of spinal metastatic disease management Review
| Authors: | Newman, W. C.; Bilsky, M. H. |
| Review Title: | Fifty-year history of the evolution of spinal metastatic disease management |
| Abstract: | Spine metastases are a significant source of morbidity in oncology. Treatment of these spine metastases largely remains palliative, but advances over the past 50 years have improved the effectiveness of interventions for preserving functional status and obtaining local control while minimizing morbidity. While the field began with conventional external beam radiation as the primary treatment modality, a series of paradigm shifts and technological advances in the 2000s led to a change in treatment patterns. These advances allowed for an increased role of surgical decompression of neural elements, a shift in the stereotactic capabilities of radiation oncologists, and an improved understanding of the radiobiology of metastatic disease. The result was improved local control while minimizing treatment morbidity. These advances fit within the larger framework of metastatic spine tumor management known as the Neurologic, Oncologic, Mechanical, and Systemic disease decision framework. This dynamic framework takes into account the neurological function of the patient, the radiobiology of their tumor, their degree of mechanical instability, and their systemic disease control and treatment options to help determine appropriate interventions based on the individual patient. Herein, we describe the 50-year evolution of metastatic spine tumor management and the impact of various advances on the field. © 2022 Wiley Periodicals LLC. |
| Keywords: | intensity modulated radiation therapy; diarrhea; multimodality cancer therapy; combined modality therapy; recurrence risk; esophagitis; mucosa inflammation; morbidity; pathology; histology; postoperative complication; dysphagia; radiation dose fractionation; decompression surgery; radiosurgery; spinal cord compression; decompression, surgical; spinal neoplasms; scoring system; stereotactic radiosurgery; external beam radiotherapy; disease management; cancer control; stereotactic body radiation therapy; fragility fracture; spine metastasis; spine tumor; kyphoplasty; en bloc resection; laminectomy; spine stereotactic radiosurgery; myositis; spinal cord decompression; neuritis; compression fracture; planning target volume; spine metastases; humans; human; article; radiation oncologist; surgical decompression; noms; costotransversectomy |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 126 |
| Issue: | 5 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2022-10-01 |
| Start Page: | 913 |
| End Page: | 920 |
| Language: | English |
| DOI: | 10.1002/jso.27028 |
| PUBMED: | 36087077 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 October 2022 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work