Radiotherapy and spinal brace: still first-choice treatment for vertebral metastases from breast cancer.
In metastatic breast cancer the goal to reach must be the best possible palliation with minimum discomfort for the patient. We reviewed our experience with radiotherapy (20 or 30 Gy), systemic therapy and brace. Among 2200 breast cancer patients, we extracted 28 potential candidates for resection. All of them developed new metastases outside the treated field within one year. Local control was achieved in 68%, and 80% of them had stable or better performance status at 3 months. From our analysis, even patients with a so called "solitary lesion" do not seem to have a better prognosis than others. We conclude that radiotherapy (with systemic therapy and a brace) is still first-choice treatment for vertebral metastases; CT-guided percutaneous biopsy can avoid worthless major operations. The role of surgery should be limited to neurological compression, severe mechanical instability and to salvage the failures of conservative treatment.
Centro di Oncologia Ortopedica, 1a Ortopedia, Ospedale Civile, Brescia.
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V
Ippolito
E
E
Micheletti
M
M
Saccalani
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F
Barbera
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S
Tonoli
C
C
Motta
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001915:Braces; D001943:Breast Neoplasms; D002574:Cervical Vertebrae; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008159:Lumbar Vertebrae; D010148:Intractable Pain / Q000209:etiology; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000628:therapy; D013629:Tamoxifen / Q000627:therapeutic use; D013904:Thoracic Vertebrae; D014750:Vincristine / Q000627:therapeutic use
D000903:Antibiotics, Antineoplastic; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D013629:Tamoxifen; D014750:Vincristine; D004317:Doxorubicin