title: Stability of spinal bone metastases in breast cancer after radiotherapy: a retrospective analysis of 157 cases.
abstract: OBJECTIVE
  This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system.
  
  
  METHODS
  The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated.
  
  
  RESULTS
  Eighty-five (54%) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70%) and 124 (79%) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5%) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83% after 5 years.
  
  
  CONCLUSIONS
  The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates.
authors.affiliation: Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany, ingmar.schlampp@med.uni-heidelberg.de.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Schlampp
authors.forename: Stefan
authors.initials: S
authors.lastname: Rieken
authors.forename: Daniel
authors.initials: D
authors.lastname: Habermehl
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Robert
authors.initials: R
authors.lastname: Förster
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Harald
authors.initials: H
authors.lastname: Rief
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D018275:Carcinoma, Lobular / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008159:Lumbar Vertebrae / Q000528:radiation effects*; D008875:Middle Aged; D010014:Osteolysis / Q000401:mortality / Q000532:radiotherapy*; D010025:Osteoradionecrosis / Q000175:diagnosis* / Q000401:mortality; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000401:mortality / Q000532:radiotherapy*; D016103:Spinal Fractures / Q000175:diagnosis / Q000401:mortality; D013125:Spinal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D013223:Statistics as Topic; D015996:Survival Rate; D013904:Thoracic Vertebrae / Q000528:radiation effects*; D014057:Tomography, X-Ray Computed