Display options
Cite
Barzilai O, Amato MK, McLaughlin L, et al. Hybrid surgery-radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes. Neurooncol Pract. 2017;5(2):104-113doi: 10.1093/nop/npx017.
Barzilai, O., Amato, M. K., McLaughlin, L., Reiner, A. S., Ogilvie, S. Q., Lis, E., Yamada, Y., Bilsky, M. H., & Laufer, I. (2018). Hybrid surgery-radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes. Neuro-oncology practice, 5(2), 104-113. https://doi.org/10.1093/nop/npx017
Barzilai, Ori, et al. "Hybrid surgery-radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes." Neuro-oncology practice vol. 5,2 (2018): 104-113. doi: https://doi.org/10.1093/nop/npx017
Barzilai O, Amato MK, McLaughlin L, Reiner AS, Ogilvie SQ, Lis E, Yamada Y, Bilsky MH, Laufer I. Hybrid surgery-radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes. Neurooncol Pract. 2018 May;5(2):104-113. doi: 10.1093/nop/npx017. Epub 2017 Jul 22. PMID: 29770224; PMCID: PMC5946922.
Copy Download .nbib Format: NLM
Share it on

Neurooncol Pract. 2018 May;5(2):104-113. doi: 10.1093/nop/npx017. Epub 2017 Jul 22.

Hybrid surgery-radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes.

Neuro-oncology practice

Ori Barzilai, Mary-Kate Amato, Lily McLaughlin, Anne S Reiner, Shahiba Q Ogilvie, Eric Lis, Yoshiya Yamada, Mark H Bilsky, Ilya Laufer

Affiliations

  1. Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center New York, New York, USA.
  2. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center New York, New York, USA.
  3. Department of Radiology, Memorial Sloan-Kettering Cancer Center New York, New York, USA.
  4. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center New York, New York, USA.
  5. Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA.

PMID: 29770224 PMCID: PMC5946922 DOI: 10.1093/nop/npx017

Abstract

BACKGROUND: Patient-reported outcomes (PRO) represent an important measure of cancer therapy effect. For patients with metastatic epidural spinal cord compression (MESCC), hybrid therapy using separation surgery and stereotactic radiosurgery preserves neurologic function and provides tumor control. There is currently a paucity of data reporting PRO after such combined modality therapy for MESCC. Delineation of hybrid surgery-radiosurgery therapy effect on PRO validates the hybrid approach as an effective therapy resulting in meaningful symptom relief.

PATIENTS AND METHODS: Brief Pain Inventory (BPI) and MD Anderson Symptom Inventory-Spine Tumor (MDASI-SP), PROs validated in the cancer population, were prospectively collected. Patients with MESCC who underwent separation surgery followed by stereotactic radiosurgery were included. Separation surgery included a posterolateral approach without extensive cytoreductive tumor excision. A median postoperative radiosurgery dose of 2700 cGy was delivered. The change in PRO 3 months after the hybrid therapy represented the primary study outcome. Preoperative and postoperative evaluations were analyzed using the Wilcoxon signed-rank test for matched pairs.

RESULTS: One hundred eleven patients were included. Hybrid therapy resulted in a significant reduction in the BPI items "worst" and "right now" pain (

CONCLUSIONS: Validated PRO instruments showed that in patients with MESCC, hybrid therapy with separation surgery and radiosurgery results in a significant decrease in pain severity and symptom interference. These prospective data confirm the benefit of hybrid therapy for treatment of MESCC and should facilitate referral of patients with MESCC for surgical evaluation.

Keywords: HRQoL; MESCC; SRS; separation surgery; spine tumor

References

  1. J Pain Symptom Manage. 2011 Mar;41(3):558-65 - PubMed
  2. Spine (Phila Pa 1976). 2011 Oct 1;36(21 Suppl):S69-74 - PubMed
  3. Spine (Phila Pa 1976). 2006 Nov 15;31(24):2849-56 - PubMed
  4. J Neurosurg Spine. 2010 Sep;13(3):324-8 - PubMed
  5. J Neurosurg Spine. 2010 Apr;12(4):421-30 - PubMed
  6. Oncologist. 2013 Jun;18(6):744-51 - PubMed
  7. Spine (Phila Pa 1976). 2016 Oct 15;41 Suppl 20:S212-S217 - PubMed
  8. Cancer. 2000 Oct 1;89(7):1634-46 - PubMed
  9. Pract Radiat Oncol. 2015 Sep-Oct;5(5):e531-6 - PubMed
  10. Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S101-7 - PubMed
  11. AJR Am J Roentgenol. 2014 Oct;203(4):869-74 - PubMed
  12. Spine (Phila Pa 1976). 2000 Sep 1;25(17):2240-9,discussion 250 - PubMed
  13. Lancet Oncol. 2012 Apr;13(4):395-402 - PubMed
  14. Neurosurg Focus. 2017 Jan;42(1):E6 - PubMed
  15. Neurosurg Focus. 2016 Aug;41(2):E11 - PubMed
  16. Spine J. 2014 Sep 1;14(9):1850-9 - PubMed
  17. Support Care Cancer. 2012 Mar;20(3):633-9 - PubMed
  18. Neurosurg Focus. 2016 Aug;41(2):E2 - PubMed
  19. J Clin Oncol. 2016 Jan 20;34(3):268-76 - PubMed
  20. Spine (Phila Pa 1976). 2010 Jun 15;35(14):1377-86 - PubMed
  21. J Neurosurg Spine. 2017 Mar;26(3):299-306 - PubMed
  22. Acta Neurochir (Wien). 1998;140(9):957-67 - PubMed
  23. Spine J. 2017 Jun;17 (6):768-776 - PubMed
  24. Clin Oncol (R Coll Radiol). 2006 Sep;18(7):539-44 - PubMed
  25. J Bone Joint Surg Br. 2009 Feb;91(2):240-4 - PubMed
  26. Cancer. 2013 Feb 15;119(4):888-96 - PubMed
  27. Lancet Oncol. 2005 Jan;6(1):15-24 - PubMed
  28. J Pain. 2008 Feb;9(2):105-21 - PubMed
  29. J Neurosurg Spine. 2014 Apr;20(4):411-20 - PubMed
  30. Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S128-34 - PubMed
  31. Int J Radiat Oncol Biol Phys. 2011 Jul 1;80(3):824-31 - PubMed
  32. Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e597-605 - PubMed
  33. Neurosurgery. 2008 Mar;62(3):683-92; discussion 683-92 - PubMed
  34. Int Orthop. 1995;19(5):309-11 - PubMed
  35. Cochrane Database Syst Rev. 2015 Sep 04;(9):CD006716 - PubMed
  36. Neurosurg Focus. 2017 Jan;42(1):E7 - PubMed
  37. J Neurosurg Spine. 2013 Mar;18(3):207-14 - PubMed
  38. J Pain Symptom Manage. 2010 Feb;39(2):230-40 - PubMed
  39. Spine (Phila Pa 1976). 2003 Mar 1;28(5):508-12 - PubMed
  40. Br J Neurosurg. 2016 Jun;30(3):337-44 - PubMed
  41. Neuro Oncol. 2013 Oct;15(10):1413-9 - PubMed
  42. Lancet. 2005 Aug 20-26;366(9486):643-8 - PubMed
  43. J Neurosurg Spine. 2015 Apr;22(4):409-15 - PubMed

Publication Types

Grant support