Local recurrence outcomes using the 32P intraoperative brachytherapy plaque in the management of malignant lesions of the spine involving the dura Journal Article
| Authors: | Folkert, M. R.; Bilsky, M. H.; Cohen, G. N.; Voros, L.; Oh, J. H.; Zaider, M.; Laufer, I.; Yamada, Y. |
| Article Title: | Local recurrence outcomes using the 32P intraoperative brachytherapy plaque in the management of malignant lesions of the spine involving the dura |
| Abstract: | Purpose: Sterilization of surgical margins for lesions involving the dura is complicated by the tolerance of the spinal cord and/or cauda equina, especially in the setting of prior radiation therapy (RT); use of intraoperative brachytherapy may allow local delivery of therapeutic dose without damaging sensitive structures. Methods and Materials: Patients with malignant lesions involving the dura received intraoperative brachytherapy with a 32P plaque after maximal resection of the tumor. Local recurrence (LR) was analyzed using competing risks analysis; overall survival was analyzed using Kaplan-Meier statistics. Results: Between September 2009 and April 2013, 68 patients with 69 lesions in the spine were treated with the 32P plaque. Median followup was 10 months. Most patients (n=59, 85.5%) had previously been treated with at least one course of prior RT to the treated site. About 38 (55%) lesions received postoperative RT (median dose, 30Gy; range, 18-30Gy). The LR and overall survival at 12 months were 25.5% (95% confidence interval [CI]=15.5-37%) and 59.5% (95% CI=46-73%), respectively. For patients who received postoperative RT, LR at 12 months was 18.5% (95% CI=7.5-33%) compared with 34% (95% CI=18-51%) for those who were treated with the plaque alone (p=0.08 and 0.04 on univariate and multivariable analysis, respectively). There were no acute or long-term complications from treatment observed in this cohort. Conclusions: The 32P intraoperative brachytherapy plaque is a useful adjunct to surgical intervention for primary recurrent and metastatic lesions of the spine involving the dura, and is not associated with additional toxicity. © 2015 American Brachytherapy Society. |
| Keywords: | adolescent; adult; child; controlled study; treatment outcome; aged; major clinical study; overall survival; cancer recurrence; treatment planning; radiation dose; nuclear magnetic resonance imaging; follow up; retrospective study; prescription; decompression surgery; spinal cord tumor; spine; brachytherapy; external beam radiotherapy; radiation safety; salvage; metastatic; intraoperative radiotherapy; recurrent; peroperative complication; multimodal imaging; dura; phosphorus 32; intraoperative radiation therapy; human; male; female; priority journal; article |
| Journal Title: | Brachytherapy |
| Volume: | 14 |
| Issue: | 2 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2015-03-01 |
| Start Page: | 202 |
| End Page: | 208 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2014.10.007 |
| PROVIDER: | scopus |
| PUBMED: | 25483021 |
| DOI/URL: | |
| Notes: | Export Date: 2 April 2015 -- Source: Scopus |
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