椎体骨折后原发性立体定向放射治疗脊柱骨转移:十年的经验。

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Kuan-Nien Chou, David J Park, Vivek Sanker, Xianghua Ye, Yusuke S Hori, Amit R Persad, Cynthia Chuang, Sara C Emrich, Louisa P Ustrzynski, Armine Tayag, Kiran A Kumar, Melissa Usoz, Maria Mendoza, Elham Rahimy, Erqi L Pollom, Scott G Soltys, Atman Desai, Cheng-Hsiang Lo, Steven D Chang
{"title":"椎体骨折后原发性立体定向放射治疗脊柱骨转移:十年的经验。","authors":"Kuan-Nien Chou, David J Park, Vivek Sanker, Xianghua Ye, Yusuke S Hori, Amit R Persad, Cynthia Chuang, Sara C Emrich, Louisa P Ustrzynski, Armine Tayag, Kiran A Kumar, Melissa Usoz, Maria Mendoza, Elham Rahimy, Erqi L Pollom, Scott G Soltys, Atman Desai, Cheng-Hsiang Lo, Steven D Chang","doi":"10.3171/2025.3.SPINE231234","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of this retrospective study was to comprehensively evaluate the factors that contribute to and protect against the occurrence of vertebral fracture (VF) following stereotactic body radiation therapy (SBRT) for the treatment of spinal bone metastasis (SBM).</p><p><strong>Methods: </strong>This study focused on adult patients who underwent primary SBRT for management of solid tumor SBMs from March 2012 to January 2023 with detailed follow-up medical records for at least 6 months. Target volume delineation for sacral and spinal SBRT was conducted in accordance with International Spine Radiosurgery Consortium guidelines and international consensus recommendations. Patients with SBM showing local progression during the follow-up period were excluded. The Spine Instability Neoplastic Score (SINS) was used to assess the relationship between various factors and the occurrence of post-SBRT VF.</p><p><strong>Results: </strong>A total of 304 patients (178 male, median age 65 years) with 450 SBMs involving 557 vertebrae were analyzed. The overall occurrence rate of VF, including post-SBRT VFs on SBRT-treated vertebrae and adjacent VFs (AVFs), was 16.6%. Post-SBRT VFs accounted for 15.6% of cases, while AVFs constituted 3.3%. Post-SBRT VFs predominantly exhibited a biconcave shape. Key factors associated with the development of post-SBRT VF included SBMs in the lumbar segment, spinal instability (SINS ≥ 7), the presence of pre-SBRT VF, and a higher radiation dose (biologically effective doses [BED3] ≥ 153.3 Gy). The use of antiresorptive agents, including bisphosphonates and denosumab, significantly reduced the occurrence rate of post-SBRT VF, with denosumab showing a particularly enhanced protective effect. Pain relief and recalcification of SBMs following SBRT were also observed.</p><p><strong>Conclusions: </strong>This study offers valuable insights into the occurrence of post-SBRT VF in SBM. While post-SBRT VF remains a significant concern in SBRT treatment, the potential for remineralization in SBM provides a promising avenue for enhancing spinal stability over time.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vertebral fracture following primary stereotactic body radiation therapy for spinal bone metastases: a decade of experience.\",\"authors\":\"Kuan-Nien Chou, David J Park, Vivek Sanker, Xianghua Ye, Yusuke S Hori, Amit R Persad, Cynthia Chuang, Sara C Emrich, Louisa P Ustrzynski, Armine Tayag, Kiran A Kumar, Melissa Usoz, Maria Mendoza, Elham Rahimy, Erqi L Pollom, Scott G Soltys, Atman Desai, Cheng-Hsiang Lo, Steven D Chang\",\"doi\":\"10.3171/2025.3.SPINE231234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of this retrospective study was to comprehensively evaluate the factors that contribute to and protect against the occurrence of vertebral fracture (VF) following stereotactic body radiation therapy (SBRT) for the treatment of spinal bone metastasis (SBM).</p><p><strong>Methods: </strong>This study focused on adult patients who underwent primary SBRT for management of solid tumor SBMs from March 2012 to January 2023 with detailed follow-up medical records for at least 6 months. Target volume delineation for sacral and spinal SBRT was conducted in accordance with International Spine Radiosurgery Consortium guidelines and international consensus recommendations. Patients with SBM showing local progression during the follow-up period were excluded. The Spine Instability Neoplastic Score (SINS) was used to assess the relationship between various factors and the occurrence of post-SBRT VF.</p><p><strong>Results: </strong>A total of 304 patients (178 male, median age 65 years) with 450 SBMs involving 557 vertebrae were analyzed. The overall occurrence rate of VF, including post-SBRT VFs on SBRT-treated vertebrae and adjacent VFs (AVFs), was 16.6%. Post-SBRT VFs accounted for 15.6% of cases, while AVFs constituted 3.3%. Post-SBRT VFs predominantly exhibited a biconcave shape. Key factors associated with the development of post-SBRT VF included SBMs in the lumbar segment, spinal instability (SINS ≥ 7), the presence of pre-SBRT VF, and a higher radiation dose (biologically effective doses [BED3] ≥ 153.3 Gy). The use of antiresorptive agents, including bisphosphonates and denosumab, significantly reduced the occurrence rate of post-SBRT VF, with denosumab showing a particularly enhanced protective effect. Pain relief and recalcification of SBMs following SBRT were also observed.</p><p><strong>Conclusions: </strong>This study offers valuable insights into the occurrence of post-SBRT VF in SBM. While post-SBRT VF remains a significant concern in SBRT treatment, the potential for remineralization in SBM provides a promising avenue for enhancing spinal stability over time.</p>\",\"PeriodicalId\":16562,\"journal\":{\"name\":\"Journal of neurosurgery. Spine\",\"volume\":\" \",\"pages\":\"1-11\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgery. Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3171/2025.3.SPINE231234\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgery. Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3171/2025.3.SPINE231234","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:本回顾性研究的目的是综合评价立体定向放射治疗(SBRT)治疗脊柱骨转移(SBM)后椎体骨折(VF)发生的因素。方法:本研究集中于2012年3月至2023年1月接受原发性SBRT治疗实体瘤SBMs的成年患者,并进行了至少6个月的详细随访记录。根据国际脊柱放射外科联盟指南和国际共识建议进行骶骨和脊柱SBRT的靶体积划定。排除随访期间局部进展的SBM患者。采用脊柱不稳定性肿瘤评分(SINS)评估各因素与sbrt后VF发生的关系。结果:共分析了304例患者(178例男性,中位年龄65岁)450例sbm,涉及557个椎骨。VF的总发生率为16.6%,包括sbrt治疗后椎骨VFs和相邻VFs (AVFs)。sbrt后VFs占15.6%,AVFs占3.3%。sbrt后VFs主要呈现双凹形。与sbrt后VF发生相关的关键因素包括腰椎段SBMs、脊柱不稳定(SINS≥7)、sbrt前VF的存在和较高的辐射剂量(生物有效剂量[BED3]≥153.3 Gy)。使用抗吸收药物,包括双磷酸盐和denosumab,可显著降低sbrt后VF的发生率,其中denosumab显示出特别增强的保护作用。SBRT后sbm疼痛缓解和再钙化也被观察到。结论:本研究为SBM术后VF的发生提供了有价值的见解。虽然SBRT后的VF仍然是SBRT治疗中的一个重要问题,但SBM中再矿化的潜力为随着时间的推移增强脊柱稳定性提供了一个有希望的途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vertebral fracture following primary stereotactic body radiation therapy for spinal bone metastases: a decade of experience.

Objective: The aim of this retrospective study was to comprehensively evaluate the factors that contribute to and protect against the occurrence of vertebral fracture (VF) following stereotactic body radiation therapy (SBRT) for the treatment of spinal bone metastasis (SBM).

Methods: This study focused on adult patients who underwent primary SBRT for management of solid tumor SBMs from March 2012 to January 2023 with detailed follow-up medical records for at least 6 months. Target volume delineation for sacral and spinal SBRT was conducted in accordance with International Spine Radiosurgery Consortium guidelines and international consensus recommendations. Patients with SBM showing local progression during the follow-up period were excluded. The Spine Instability Neoplastic Score (SINS) was used to assess the relationship between various factors and the occurrence of post-SBRT VF.

Results: A total of 304 patients (178 male, median age 65 years) with 450 SBMs involving 557 vertebrae were analyzed. The overall occurrence rate of VF, including post-SBRT VFs on SBRT-treated vertebrae and adjacent VFs (AVFs), was 16.6%. Post-SBRT VFs accounted for 15.6% of cases, while AVFs constituted 3.3%. Post-SBRT VFs predominantly exhibited a biconcave shape. Key factors associated with the development of post-SBRT VF included SBMs in the lumbar segment, spinal instability (SINS ≥ 7), the presence of pre-SBRT VF, and a higher radiation dose (biologically effective doses [BED3] ≥ 153.3 Gy). The use of antiresorptive agents, including bisphosphonates and denosumab, significantly reduced the occurrence rate of post-SBRT VF, with denosumab showing a particularly enhanced protective effect. Pain relief and recalcification of SBMs following SBRT were also observed.

Conclusions: This study offers valuable insights into the occurrence of post-SBRT VF in SBM. While post-SBRT VF remains a significant concern in SBRT treatment, the potential for remineralization in SBM provides a promising avenue for enhancing spinal stability over time.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信