Patterns of failure after single-dose radiosurgery for spinal metastasis.
OBJECTIVE
Single-dose radiosurgery for solitary spinal metastases can achieve rapid and durable pain control. This study was conducted to determine the patterns of failure after spinal radiosurgery.


METHODS
Forty-nine patients with 61 solitary spinal metastases underwent radiosurgery between May 2001 and May 2003. Single-dose radiosurgery (10-16 Gy) was delivered only to the involved spinal segments. The authors undertook a retrospective review of clinical notes, including patient questionnaires and radiological studies (computerized tomography or magnetic resonance imaging), to analyze patterns of failure following radiosurgery with regard to the pain and tumor control. Complete and partial pain relief was achieved in 85% of the lesions treated. Relapse of pain at the treated site was noted in 7%. Radiologically, lesions progressively metastasized to the immediately adjacent spines in 5%. These patients also had progressive primary and/or other systemic metastatic diseases.


CONCLUSIONS
Spine-related pain control/reduction was excellent. Tumor recurrence at the treated segment and progression to the immediately adjacent region were rare. The results support the use of spinal radiosurgery as an effective treatment option for solitary spinal metastasis.
Ryu
Samuel
S
Departments of Radiation Oncology and Neurosurgery, Henry Ford Hospital, Detroit, Michigan, 48202, USA. sryu1@hfhs.org
Rock
Jack
J
Rosenblum
Mark
M
Kim
Jae Ho
JH
D000328:Adult; D000368:Aged; D018450:Disease Progression; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010166:Palliative Care / Q000592:standards; D016634:Radiosurgery / Q000592:standards*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure