The Metastatic Spine Disease Multidisciplinary Working Group Algorithms.
The Metastatic Spine Disease Multidisciplinary Working Group consists of medical and radiation oncologists, surgeons, and interventional radiologists from multiple comprehensive cancer centers who have developed evidence- and expert opinion-based algorithms for managing metastatic spine disease. The purpose of these algorithms is to facilitate interdisciplinary referrals by providing physicians with straightforward recommendations regarding the use of available treatment options, including emerging modalities such as stereotactic body radiation therapy and percutaneous tumor ablation. This consensus document details the evidence supporting the Working Group algorithms and includes illustrative cases to demonstrate how the algorithms may be applied.
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA wallacea@mir.wustl.edu.
Adam N
AN
Wallace
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Clifford G
CG
Robinson
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Jeffrey
J
Meyer
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Nam D
ND
Tran
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Afshin
A
Gangi
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Matthew R
MR
Callstrom
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Samuel T
ST
Chao
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Brian A
BA
Van Tine
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Jonathan M
JM
Morris
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Brian M
BM
Bruel
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Jeremiah
J
Long
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Robert D
RD
Timmerman
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Jacob M
JM
Buchowski
Mallinckrodt Institute of Radiology, Department of Radiation Oncology, Department of Internal Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Neurooncology Program, H. Lee Moffitt Cancer Center and Research Institute, Department of Neurosurgery, and Department of Orthopedics, University of South Florida College of Medicine, Tampa, Florida, USA; Department of Interventional Radiology, University of Strasbourg School of Medicine, Strasbourg, France; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesiology and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Jack W
JW
Jennings
D003131:Combined Modality Therapy; D050815:Fractures, Compression / Q000209:etiology / Q000628:therapy; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D013117:Spinal Cord Compression / Q000209:etiology / Q000628:therapy; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary / Q000628:therapy*
Ablation techniques; Kyphoplasty; Metastatic; Radiotherapy; Spine; Vertebroplasty