Current treatment modalities for spinal metastases secondary to thyroid carcinoma.
BACKGROUND
The spine is the most common site of bone metastases due to thyroid cancer, which develop in more than 3% of patients with well-differentiated thyroid cancer. Nearly half of patients with bone metastases from thyroid cancer develop vertebral metastases. Spinal metastases are associated with significantly reduced quality of life due to pain, neurological deficit, and increased mortality.


CONCLUSIONS
Treatment options for patients with thyroid spinal metastases include radioiodine therapy, pharmacologic therapy, and surgical treatments, with recent advances in radiosurgery and minimally invasive spinal surgery as well. Therapeutic interventions require a multidisciplinary approach and aim to control pain, preserve or improve neurologic function, optimize local tumor control, and improve quality of life. We have proposed a three-tiered approach to the management and practical algorithms for patients with spinal metastases from thyroid carcinoma.


CONCLUSIONS
The introduction of novel and improved techniques for the treatment of spinal metastases has created the opportunity to significantly improve control of metastatic tumor growth and the quality of life for the patients with spinal metastases from thyroid cancer. In order for these options to be effectively used, a multidisciplinary approach must be applied in the management of the patients with thyroid spinal metastases.
1 Department of Internal Medicine, MedStar Washington Hospital Center , Washington, District of Columbia.
Yevgeniya S
YS
Kushchayeva
Sergiy V
SV
Kushchayev
Jason A
JA
Wexler
Nancy M
NM
Carroll
Mark C
MC
Preul
Oleg M
OM
Teytelboym
Volker K H
VK
Sonntag
Douglas
D
Van Nostrand
Kenneth D
KD
Burman
Lisa M
LM
Boyle
D000465:Algorithms; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D019091:Critical Pathways; D006801:Humans; D018579:Patient Selection; D011788:Quality of Life; D013125:Spinal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome