Timing of surgery and radiotherapy in the management of metastatic spine disease: expert opinion.

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  • Additional Information
    • Source:
      Publisher: OSS Press Ltd Country of Publication: China NLM ID: 101685460 Publication Model: Print Cited Medium: Print ISSN: 2414-469X (Print) Linking ISSN: 24144630 NLM ISO Abbreviation: J Spine Surg Subsets: PubMed not MEDLINE
    • Publication Information:
      Original Publication: Hong Kong : OSS Press Ltd, [2015]-
    • Abstract:
      Background: Combined surgery and radiotherapy, in the treatment of metastatic disease of the spine, is now emerging as the gold standard of care where there is an indication for spinal stabilization and/or surgical decompression. However potential complications related to wound healing can occur with radiation delivered shortly before or after to surgery. The purpose of this study was to understand the practice of leading radiation oncologists and spine surgeons with regards to the timing of radiation (conventional and stereotactic) and surgery for the management of spinal metastases.
      Methods: Questionnaires were sent to leading radiation oncologists and spine surgeons throughout North America and completed via mail, email or internet.
      Results: Eighty-six responses were received from radiation oncologists and 27 from spine surgeons. A total of 58% recommended waiting either 1 or 2 weeks after radiotherapy before operating on patients with spinal metastases. With radiotherapy administered after surgery, 62% of respondents suggested either a 1 or 2 weeks interval was sufficient.
      Conclusions: There appeared to be no significant difference in practice with the use of stereotactic radiotherapy though surgeons tend to accept a shorter interval in this subset of patients. We recommend that the interval between radiotherapy and surgery (and vice versa) should ideally be a minimum of 2 weeks.
      Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
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    • Contributed Indexing:
      Keywords: Radiotherapy; neoplasm metastasis; spinal neoplasms/radiotherapy; spinal neoplasms/surgery; wound healing
    • Publication Date:
      Date Created: 20180803 Latest Revision: 20220318
    • Publication Date:
      20240829
    • Accession Number:
      PMC6046325
    • Accession Number:
      10.21037/jss.2018.05.05
    • Accession Number:
      30069530