Local recurrence outcomes using the ³²P intraoperative brachytherapy plaque in the management of malignant lesions of the spine involving the dura.
Brachytherapy
; 14(2): 202-8, 2015.
Article
em En
| MEDLINE
| ID: mdl-25483021
ABSTRACT
PURPOSE:
Sterilization of surgical margins for lesions involving the dura is complicated by the tolerance of the spinal cord and/or cauda equina, especially in the setting of prior radiation therapy (RT); use of intraoperative brachytherapy may allow local delivery of therapeutic dose without damaging sensitive structures. METHODS AND MATERIALS Patients with malignant lesions involving the dura received intraoperative brachytherapy with a (32)P plaque after maximal resection of the tumor. Local recurrence (LR) was analyzed using competing risks analysis; overall survival was analyzed using Kaplan-Meier statistics.RESULTS:
Between September 2009 and April 2013, 68 patients with 69 lesions in the spine were treated with the (32)P plaque. Median followup was 10 months. Most patients (n=59, 85.5%) had previously been treated with at least one course of prior RT to the treated site. About 38 (55%) lesions received postoperative RT (median dose, 30 Gy; range, 18-30 Gy). The LR and overall survival at 12 months were 25.5% (95% confidence interval [CI]=15.5-37%) and 59.5% (95% CI=46-73%), respectively. For patients who received postoperative RT, LR at 12 months was 18.5% (95% CI=7.5-33%) compared with 34% (95% CI=18-51%) for those who were treated with the plaque alone (p=0.08 and 0.04 on univariate and multivariable analysis, respectively). There were no acute or long-term complications from treatment observed in this cohort.CONCLUSIONS:
The (32)P intraoperative brachytherapy plaque is a useful adjunct to surgical intervention for primary recurrent and metastatic lesions of the spine involving the dura, and is not associated with additional toxicity.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Radioisótopos de Fósforo
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Neoplasias da Medula Espinal
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Braquiterapia
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Dura-Máter
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Vértebras Lombares
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Recidiva Local de Neoplasia
Tipo de estudo:
Diagnostic_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article