PDF(Pubmed)
Abstract：
UNASSIGNED: Osteolytic spinal metastases (SM) have a higher risk of fracture. In this study we aim to confirm the remineralization of lytic SM after radiation therapy. Secondary the influence of SBRT compared to cEBRT and tumor type will be analyzed.
UNASSIGNED: A retrospective cohort study was performed.
UNASSIGNED: 87 patients, 100 SM were included. 29 received SBRT, 71 cEBRT. Most common primary tumors were breast (35 %), lung (26 %) and renal (11 %). Both cEBRT and SBRT resulted in a significant increase of bone mineral density (BMD) (83.76 HU ± 5.72 → 241.41 HU ± 22.58 (p < 0.001) and 82.45 ± 9.13 → 179.38 ± 47.83p = 0.026). There was a significant increase in absolute difference of BMD between the SM and reference vertebrae (p < 0.001). There was no significant difference between SBRT and cEBRT. There was no increase of BMD in renal lytic SM after radiation therapy (pre-treatment: 85.96 HU ± 19.07; 3 m 92.00 HU ± 21.86 (p = 0.882); 6 m 92.06 HU ± 23.94 (p = 0.902); 9 m 70.44 HU ± 7.45 (p = 0.213); 12 m 98.08 HU ± 11.24 (p = 0.740)). In all other primary tumors, a significant increase of BMD after radiation therapy was demonstrated (p < 0,05).
UNASSIGNED: We conclude that the BMD of lytic SM increases significantly after radiation therapy. Lytic SM of primary renal tumors are the exception; there is no significant remineralization of renal lytic SM after radiation therapy. There is no benefit of SBRT over cEBRT in this remineralization. These findings should be taken into account when deciding on surgery in the potentially unstable group defined by the spinal instability neoplastic score.
UNASSIGNED: A retrospective cohort study was performed.
UNASSIGNED: 87 patients, 100 SM were included. 29 received SBRT, 71 cEBRT. Most common primary tumors were breast (35 %), lung (26 %) and renal (11 %). Both cEBRT and SBRT resulted in a significant increase of bone mineral density (BMD) (83.76 HU ± 5.72 → 241.41 HU ± 22.58 (p < 0.001) and 82.45 ± 9.13 → 179.38 ± 47.83p = 0.026). There was a significant increase in absolute difference of BMD between the SM and reference vertebrae (p < 0.001). There was no significant difference between SBRT and cEBRT. There was no increase of BMD in renal lytic SM after radiation therapy (pre-treatment: 85.96 HU ± 19.07; 3 m 92.00 HU ± 21.86 (p = 0.882); 6 m 92.06 HU ± 23.94 (p = 0.902); 9 m 70.44 HU ± 7.45 (p = 0.213); 12 m 98.08 HU ± 11.24 (p = 0.740)). In all other primary tumors, a significant increase of BMD after radiation therapy was demonstrated (p < 0,05).
UNASSIGNED: We conclude that the BMD of lytic SM increases significantly after radiation therapy. Lytic SM of primary renal tumors are the exception; there is no significant remineralization of renal lytic SM after radiation therapy. There is no benefit of SBRT over cEBRT in this remineralization. These findings should be taken into account when deciding on surgery in the potentially unstable group defined by the spinal instability neoplastic score.
摘要：
■溶骨性脊柱转移瘤（SM）具有较高的骨折风险。在这项研究中，我们旨在确认放射疗法后溶解性SM的再矿化。其次,将分析SBRT与cEBRT和肿瘤类型相比的影响。
■进行了一项回顾性队列研究。
■87名患者，包括100SM。29收到SBRT，71cEBRT。最常见的原发肿瘤是乳腺（35%），肺(26%)和肾(11%)。cEBRT和SBRT均导致骨矿物质密度（BMD）显着增加（83.76HU±5.72→241.41HU±22.58（p<0.001）和82.45±9.13→179.38±47.83p=0.026）。SM和参考椎骨之间的BMD绝对差异显着增加（p<0.001）。SBRT与cEBRT之间无显著差别。放射治疗后肾脏溶解性SM的BMD没有增加（治疗前：85.96HU±19.07；3m92.00HU±21.86（p=0.882）；6m92.06HU±23.94（p=0.902）；9m70.44HU±7.45（p=0.213）；12m98.08HU±11.24（p=0.740））。在所有其他原发性肿瘤中，放射治疗后BMD显着增加（p<0.05）。
■我们得出结论，放射治疗后裂解SM的BMD显着增加。原发性肾脏肿瘤的溶解性SM是例外；放射治疗后肾脏溶解性SM没有明显的再矿化。在这种再矿化中,SBRT没有优于cEBRT的益处。在决定由脊柱不稳定肿瘤评分定义的潜在不稳定组的手术时，应考虑这些发现。
■进行了一项回顾性队列研究。
■87名患者，包括100SM。29收到SBRT，71cEBRT。最常见的原发肿瘤是乳腺（35%），肺(26%)和肾(11%)。cEBRT和SBRT均导致骨矿物质密度（BMD）显着增加（83.76HU±5.72→241.41HU±22.58（p<0.001）和82.45±9.13→179.38±47.83p=0.026）。SM和参考椎骨之间的BMD绝对差异显着增加（p<0.001）。SBRT与cEBRT之间无显著差别。放射治疗后肾脏溶解性SM的BMD没有增加（治疗前：85.96HU±19.07；3m92.00HU±21.86（p=0.882）；6m92.06HU±23.94（p=0.902）；9m70.44HU±7.45（p=0.213）；12m98.08HU±11.24（p=0.740））。在所有其他原发性肿瘤中，放射治疗后BMD显着增加（p<0.05）。
■我们得出结论，放射治疗后裂解SM的BMD显着增加。原发性肾脏肿瘤的溶解性SM是例外；放射治疗后肾脏溶解性SM没有明显的再矿化。在这种再矿化中,SBRT没有优于cEBRT的益处。在决定由脊柱不稳定肿瘤评分定义的潜在不稳定组的手术时，应考虑这些发现。
