RATIONALE: Radiotherapy has been a conventional approach in managing spinal metastases. However, surgical reduction decompressing the spinal cord circumferentially, followed by reconstruction and immediate stabilization, has proven to be effective, likewise.
OBJECTIVE: To quantitatively evaluate and compare the surgical reduction and radiotherapy results, based on pre- and post- screening data in the literature.
METHODS: Cumulative success rates from both treatment modalities were collected from 32 surgical studies presenting 1,022 adult cohorts, 6 radiation studies presenting 486 adult cohorts, and were quantified for heterogeneity using a mixed-effect and meta-regression models. The following Mesh terms were employed to recruit the data from PubMed, SCOPUS, and Medline as to the main goal of the study: circumferential spinal cord decompression, Ewing’s sarcoma; laminectomy, multiple myeloma, neuroblastoma, pancreatic cancer; prostate cancer; radiosenstive tumor; renal cancer; reconstruction, seminoma, and stabilization. The ambulatory status of operated or radiated patients was considered as the primary measurable outcome. The status was measured with the help of a developed screening tool combining the Brice and McKissock scale, Cooper scale, Frankel score, and Tomita scale. The number of spinal lesions was considered as an index unit.
RESULTS: Operated patients were twice as likely to regain fitness. The success-outcome rates for surgery and radiation cohorts were 81% and 69% respectively, with high specificity (97%) and low sensitivity (92%) to results.
CONCLUSION: Laminectomy should be considered as the primary choice in treatment of spinal metastases and can be combined with radiation therapy.
KEYWORDS: Ewing’s sarcoma; Laminectomy, Lymphoma, Multiple myeloma, Neuroblastoma, Pancreatic cancer; Prostate cancer; Radiosenstive tumor; Renal cancer; Seminoma; Vertebrae.
- Ewing’s sarcoma; Laminectomy,
- Multiple myeloma,
- Prostate cancer; Pancreatic cancer; Radiosenstive tumor; Renal cancer; Seminoma; Vertebrae
Available at: http://works.bepress.com/amertz/173/