Metastatic/Myeloma Disease—Nonoperative Management

The spine is the most common site of skeletal metastases, although rates of metastases vary widely depending on the primary tumor. Patients with spinal metastases, and their clinicians, require systematic appraisals of current evidence regarding treatment options in order to promote evidence‐based d...

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Published inEvidence‐Based Orthopedics pp. 728 - 734
Main Authors Malempati, Harsha, Qamirani, Erion, Yee, Albert J. M
Format Book Chapter
LanguageEnglish
Published Oxford, UK Wiley‐Blackwell 09.12.2011
Subjects
bisphosphonates
fractionated radiation
radiation
radiopharmaceutical
radiotherapy
Spine metastasis
stereotactic radiosurgery
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Summary:The spine is the most common site of skeletal metastases, although rates of metastases vary widely depending on the primary tumor. Patients with spinal metastases, and their clinicians, require systematic appraisals of current evidence regarding treatment options in order to promote evidence‐based decision‐making. Our literature review addresses non‐operative management of spinal metastases. Current evidence suggests that bisphosphonates and radiopharmaceuticals play an important role in the palliative management of metastatic disease affecting the spine. Single fraction radiotherapy has also been shown to be effective and multiple fraction radiotherapy does not show increased efficacy. There is preliminary evidence to suggest that stereotactic radiosurgery may be efficacious in the treatment of some radioresistant metastases affecting the spine. However, further research is required to assess this emerging treatment option.
ISBN:9781405184762
1405184760
DOI:10.1002/9781444345100.ch85