Database : MEDLINE
Search on : Epidural and Neoplasms [Words]
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[PMID]: 29420378
[Au] Autor:Xu H; Tong M; Liu J; Zhou G; Chen F
[Ad] Address:Department of Neurosurgery, Jinhua Central Hospital, Jinhua City, China.
[Ti] Title:Purely Spinal Epidural Capillary Hemangiomas.
[So] Source:J Craniofac Surg;, 2018 Feb 07.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Capillary hemangiomas (CAs) are benign endothelial cell neoplasms that are often encountered superficially in the soft tissues of the head and neck region. Most of the reported purely spinal epidural hemangiomas have been of cavernous type, and the occurrence of purely spinal epidural CA is exceedingly rare, and there are only 12 reported cases of spinal epidural CAs in the English literature. Herein, the authors report the 13th case of purely spinal epidural CAs, and the clinical characteristics, histopathological features, and treatment were also investigated.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[St] Status:Publisher
[do] DOI:10.1097/SCS.0000000000004366

  2 / 4235 MEDLINE  
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[PMID]: 29369169
[Au] Autor:Dong R; Ji J; Liu H; Wang J; He X
[Ad] Address:Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine.
[Ti] Title:Primary spinal mucosa-associated lymphoid tissue lymphoma: A case report.
[So] Source:Medicine (Baltimore);97(4):e9329, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B-cell lymphoma which occurs mainly in the organs having mucosal layer and owns a fairly good prognosis. To date, 7 cases of spinal primary MALT has been reported before. However, there is no consensus on the optimal adjuvant treatment modalities for primary spinal MALT. The aim of this study was to add a new case of MALT which responded well to systemic therapy to the literature and to review the current literature. PATIENT CONCERNS: A 68-year-old woman visited to our hospital due to back pain and progressive bilateral lower extremity weakness for 2 months. Magnetic resonance imaging (MRI) of the spine revealed a diffusely contrast-enhancing epidural mass extending from vertebral body T6 to T8 with compression of the spinal cord. Due to the spinal cord compression, patient underwent surgical resection. Histological examination indicated monocytoid small B-cells. Immunochemical study demonstrates that most tumor cells were positive for CD20, CD21, CD45, CD79a, CD43, bcl-2 with Ki-67 labing index was 15%, but were negative for CD3, CD5 cyclin D1, BCL6, and CD23. The positron emission tomography/computer tomography (PET/CT) revealed that right iliac wing and right liver were metastases for the standard uptake value (SUV) were 9.05 and 8.35, respectively. DIAGNOSES: Based on these findings, final diagnosis of spinal MALT lymphoma was made. INTERVENTIONS: After the diagnosis, the patient received 6 cycles of immuno-chemotherapy and repeated intrathecal methotrexate and intrathecal cytarabine. OUTCOMES: At 1 year follow up, no recurrence or other dissemination was detected. LESSONS: Chemotherapy and/or radiation have been employed in larger case series. While there is no defined treatment guideline for this rare disease entity, our reported case suggests a favorable prognosis when combining both surgical and adjuvant systemic approach.
[Mh] MeSH terms primary: Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
Positron Emission Tomography Computed Tomography/methods
Spinal Neoplasms/diagnostic imaging
[Mh] MeSH terms secundary: Aged
Antineoplastic Agents/therapeutic use
Cytarabine/therapeutic use
Female
Humans
Lymphoma, B-Cell, Marginal Zone/drug therapy
Lymphoma, B-Cell, Marginal Zone/pathology
Methotrexate/therapeutic use
Spinal Neoplasms/drug therapy
Spinal Neoplasms/pathology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Antineoplastic Agents); 04079A1RDZ (Cytarabine); YL5FZ2Y5U1 (Methotrexate)
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009329

  3 / 4235 MEDLINE  
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[PMID]: 29398191
[Au] Autor:Huang KT; McAvoy M; Helgager J; Vasudeva V; Chi JH
[Ad] Address:Brigham and Women's Hospital, Harvard Medical School, Department of Neurosurgery, 75 Francis Street, Boston, MA 02115, United States.
[Ti] Title:Spinal hemangioma mimicking a dumbbell-shaped schwannoma: Case report and review of the literature.
[So] Source:J Clin Neurosci;, 2018 Feb 01.
[Is] ISSN:1532-2653
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:Spinal hemangiomas are common, benign vascular lesions that involve the bony portion of vertebral bodies and are generally asymptomatic. Rarely, they can become aggressive and present with predominantly epidural extension, mimicking other neoplasms. We present the case of a fifty-one year old woman who presented with myelopathy and was discovered to have a large mass causing epidural spinal cord compression, thought to be due to a peripheral nerve sheath tumor. She underwent surgery for tumor debulking. Intraoperatively, the mass was found to be mostly epidural with minimal bone involvement. Final pathology demonstrated a cavernous hemangioma. The patient did well post-operatively, with resolution of symptoms and stable size of residual tumor on eighteen month follow-up imaging.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180205
[Lr] Last revision date:180205
[St] Status:Publisher

  4 / 4235 MEDLINE  
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[PMID]: 28973637
[Au] Autor:Zaazoue MA; Bedewy M; Goumnerova LC
[Ad] Address:Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts.
[Ti] Title:Complications of Head Immobilization Devices in Children: Contact Mechanics, and Analysis of a Single Institutional Experience.
[So] Source:Neurosurgery;, 2017 Jun 20.
[Is] ISSN:1524-4040
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Head immobilization devices (HIDs) are a staple of neurosurgical procedures, including in the intraoperative magnetic resonance imaging (iMRI) operating rooms (ORs) where material modifications were necessary for compatibility with the magnets utilized. OBJECTIVE: To present the experience in this OR environment and discuss the multifactorial nature of the observed adverse events. METHODS: A retrospective chart review was performed, utilizing the Department of Neurosurgery and iMRI OR databases to identify patients who suffered complications related to HIDs between November 2007 and March 2016. A literature review was also done to identify the magnitude of the problem and the availability of safety guidelines. RESULTS: Nine hundred and forty patients underwent surgery in the iMRI OR requiring head immobilization. Seven (0.7%) suffered complications related to the HID-depressed skull fractures ( n = 7) and epidural hematomas ( n = 6). Age at surgery ranged from 1.6 to 10.3 yr. All patients had posterior fossa neoplasms and associated obstructive hydrocephalus. Four patients (57%) suffered permanent neurological deficits. Six patients (86%) underwent a surgical procedure to evacuate the epidural hematomas and repair the depressed skull fracture. In contrast, 1 out of 445 patient (0.2%) suffered HID-related adverse events in the conventional ORs, aged 10.2 yr. CONCLUSION: HIDs are important to provide stability and support during neurosurgical procedures. Modifications in the material or the shape of the pins can significantly change the pressure exerted. Most of these complications are preventable if certain precautionary measures are taken especially in certain high-risk patients, and the overall benefits of HIDs continue to outweigh the risks. There is a need for consensus on guidelines for the safe use of these devices.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171003
[Lr] Last revision date:171003
[St] Status:Publisher
[do] DOI:10.1093/neuros/nyx315

  5 / 4235 MEDLINE  
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[PMID]: 28953631
[Au] Autor:Jin LJ; Wen LY; Zhang YL; Li G; Sun P; Zhou X
[Ad] Address:aDepartment of Anesthesia bDepartment of Orthopaedics, The Affiliated Hongqi Hospital of Mudanjiang Medical University cDepartment of Anatomy, Mudanjiang Medical University, Mudanjiang, China.
[Ti] Title:Thoracic paravertebral regional anesthesia for pain relief in patients with breast cancer surgery.
[So] Source:Medicine (Baltimore);96(39):e8107, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The present study aimed to assess the efficacy and safety of thoracic paravertebral regional anesthesia (TPVBRA) in patients with breast cancer surgery. METHODS: In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects. Both groups received TPVBRA with 20 mL 0.25% bupivacaine. In addition, subjects in the intervention group also received an additional 1 µg/kg dexmedetomidine. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pain intensity (measured by visual analogue scale, VAS), and analgesic consumption were assessed; adverse events were also recorded. RESULTS: Significant differences were observed in HR (P < .05), SBP (P < .05), and DBP (P < .05) at the 30-minute point during surgery between the 2 groups. In addition, the time of the first administration of analgesia (P = .043) and the mean consumption of analgesic agents (P = .035) in the intervention group were much better than those in the control group. However, no significant differences in HR or VAS were found at any time point after surgery (P > .05). Furthermore, similar adverse events were detected in both groups (P > .05). CONCLUSION: The results of this study showed that TPVBRA combined with bupivacaine and dexmedetomidine can enhance the duration and quality of analgesia without serious adverse events.
[Mh] MeSH terms primary: Analgesics, Non-Narcotic/administration & dosage
Anesthesia, Epidural/methods
Anesthetics, Local/administration & dosage
Breast Neoplasms/surgery
Pain, Postoperative/prevention & control
[Mh] MeSH terms secundary: Aged
Bupivacaine/administration & dosage
Dexmedetomidine/administration & dosage
Female
Humans
Middle Aged
Pain Measurement
Pain, Postoperative/drug therapy
Thoracic Vertebrae
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Name of substance:0 (Analgesics, Non-Narcotic); 0 (Anesthetics, Local); 67VB76HONO (Dexmedetomidine); Y8335394RO (Bupivacaine)
[Em] Entry month:1710
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008107

  6 / 4235 MEDLINE  
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[PMID]: 28881116
[Au] Autor:Kim SI; Kim YH; Ha KY; Lee JW; Lee JW
[Ad] Address:Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
[Ti] Title:Surgical Roles for Spinal Involvement of Hematological Malignancies.
[So] Source:J Korean Neurosurg Soc;60(5):534-539, 2017 Sep.
[Is] ISSN:2005-3711
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. METHODS: From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. RESULTS: The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). CONCLUSION: Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170914
[Lr] Last revision date:170914
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3340/jkns.2016.1011.001

  7 / 4235 MEDLINE  
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[PMID]: 28857802
[Au] Autor:Lee EK; Ahn HJ; Zo JI; Kim K; Jung DM; Park JH
[Ad] Address:From the *Department of Anesthesiology and Pain Medicine and †Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; and ‡Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
[Ti] Title:Paravertebral Block Does Not Reduce Cancer Recurrence, but Is Related to Higher Overall Survival in Lung Cancer Surgery: A Retrospective Cohort Study.
[So] Source:Anesth Analg;125(4):1322-1328, 2017 Oct.
[Is] ISSN:1526-7598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postoperative analgesic methods are suggested to have an impact on long-term prognosis after cancer surgery through opioid-induced immune suppression. We hypothesized that regional analgesia that reduces the systemic opioid requirement would be related to lower cancer recurrence and higher overall survival compared to intravenous patient-controlled analgesia (PCA) for lung cancer surgery. METHODS: Records for all patients who underwent open thoracotomy for curative resection of primary lung cancer between 2009 and 2013 in a tertiary care hospital were retrospectively analyzed. Patients were divided by postoperative analgesic methods: PCA (n = 574), thoracic epidural analgesia (TEA, n = 619), or paravertebral block (PVB, n = 536). Overall and recurrence-free survivals were compared among 3 analgesic methods via a multivariable Cox proportional hazard model and a log-rank test after adjusting confounding factors using propensity score matching (PSM). RESULTS: Analgesic method was associated with overall survival (P= .0015; hazard ratio against TEA [95% confidence intervals]: 0.58 [0.39-0.87] for PCA, 0.60 [0.45-0.79] for PVB). After confounder adjustment using PSM, PVB showed higher overall survival than PCA (log-rank P= .0229) and TEA (log-rank P= .0063) while PCA and TEA showed no difference (log-rank P= .6). Hazard ratio for PVB was 0.66 [0.46-0.94] against PCA and 0.65 [0.48-0.89] against TEA after PSM. However, there was no significant association between the analgesic methods and recurrence-free survival (P= .5; log-rank P with PSM = .5 between PCA and TEA, .5 between PCA and PVB, .1 between TEA and PVB). CONCLUSIONS: Pain-control methods are not related to cancer recurrence. However, PVB may have a beneficial effect on overall survival of patients with lung cancer.
[Mh] MeSH terms primary: Analgesia, Patient-Controlled/trends
Anesthesia, Conduction/trends
Lung Neoplasms/surgery
Neoplasm Recurrence, Local/prevention & control
Nerve Block/trends
[Mh] MeSH terms secundary: Aged
Analgesia, Patient-Controlled/mortality
Anesthesia, Conduction/mortality
Cohort Studies
Female
Follow-Up Studies
Humans
Lung Neoplasms/diagnosis
Lung Neoplasms/mortality
Male
Middle Aged
Neoplasm Recurrence, Local/diagnosis
Neoplasm Recurrence, Local/mortality
Nerve Block/mortality
Retrospective Studies
Survival Rate/trends
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171004
[Lr] Last revision date:171004
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170901
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002342

  8 / 4235 MEDLINE  
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[PMID]: 28719887
[Au] Autor:Mendonça FT; Guimarães MM; de Matos SH; Dusi RG
[Ad] Address:Anesthesiology of the Hospital de Base do Distrito Federal, DF, Brazil. Electronic address: fabricio.tavares@me.com.
[Ti] Title:Anesthetic management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC): The importance of hydro-electrolytic and acid-basic control.
[So] Source:Int J Surg Case Rep;38:1-4, 2017.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block. Volume replacement was performed with crystalloids, colloids and blood products to support an important ascites volume drained during the procedure. The target was the strict control of hydro-electrolytic and acid-basic equilibrium. The patient was referred to the ICU and evolved to a hospital discharge on the third postoperative day. CONCLUSION: The neoplastic compromise of the peritoneum has long been considered to be a pre-terminal state. The advent of CRS/HIPEC represent an alternative promising with numerous challenges to the anesthesiologist regarding the metabolic and hemodynamic adjustment, which once again demand training and ongoing study from the perioperative team.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170818
[Lr] Last revision date:170818
[St] Status:PubMed-not-MEDLINE

  9 / 4235 MEDLINE  
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[PMID]: 28694590
[Au] Autor:Shweikeh F; Sangtani A; Steinmetz MP; Zahos P; Chopko B
[Ad] Address:Summa Health System, Northeast Ohio Medical University, Rootstown, USA.
[Ti] Title:Spinal angiolipomas: A puzzling case and review of a rare entity.
[So] Source:J Craniovertebr Junction Spine;8(2):91-96, 2017 Apr-Jun.
[Is] ISSN:0974-8237
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Patients with spinal epidural abscesses (SEAs) may have a variable presentation. Such an infection has a typical appearance on magnetic resonance imaging (MRI) and enhances with gadolinium. We present a case that was a diagnostic challenge where pre- and intra-operative findings resulted in conflicting impressions. The mimicker was a spinal angiolipoma (SAL). The authors then provide a thorough review of this rare spinal neoplasm. A 55-year-old man presented with back pain, paresis, paresthesia, and urinary retention. MRI was indicative of a longitudinal epidural thoracic mass with a signal homogeneous to nearby fat, curvilinear vessels, and lack of enhancement. Although at emergent surgery, the lesion was found to contain abundant purulent material. Microbiology was positive for methicillin-resistant and consistent with SEA without evidence of neoplasia. While the imaging features were suggestive of an angiolipoma, the findings at surgery made SEA more likely, which were validated histopathologically. The diagnosis of SEA is often clear-cut, and the literature has reported only a few instances in which it masqueraded as another process such as lymphoma or myelitis. The case highlights SEA masquerading as an angiolipoma, and further demonstrates to clinicians that obtaining tissue diagnosis plays a crucial role diagnostically and therapeutically. SALs, on the other hand, are slow-growing tumors that can be infiltrating or noninfiltrating. They typically present with chronic symptoms and T1-MRI shows an inhomogeneous picture. Complete surgical excision is standard of care and patients tend to do well afterward.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/jcvjs.JCVJS_23_17

  10 / 4235 MEDLINE  
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[PMID]: 28644075
[Au] Autor:Bishop AJ; Tao R; Guadagnolo BA; Allen PK; Rebueno NC; Wang XA; Amini B; Tatsui CE; Rhines LD; Li J; Chang EL; Brown PD; Ghia AJ
[Ad] Address:Departments of 1 Radiation Oncology.
[Ti] Title:Spine stereotactic radiosurgery for metastatic sarcoma: patterns of failure and radiation treatment volume considerations.
[So] Source:J Neurosurg Spine;27(3):303-311, 2017 Sep.
[Is] ISSN:1547-5646
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE Given the relatively lower radiosensitivity of sarcomas and the locally infiltrative patterns of spread, the authors sought to investigate spine stereotactic radiosurgery (SSRS) outcomes for metastatic sarcomas and to analyze patterns of failure. METHODS The records of 48 patients with 66 sarcoma spinal metastases consecutively treated with SSRS between 2002 and 2013 were reviewed. The Kaplan-Meier method was used to estimate rates of overall survival (OS) and local control (LC). Local recurrences were categorized as occurring infield (within the 95% isodose line [IDL]), marginally (between the 20% and 95% IDLs), or out of field. RESULTS Median follow-up time was 19 months (range 1-121 months), and median age was 53 years (range 17-85 years). The most commonly treated histology was leiomyosarcoma (42%). Approximately two-thirds of the patients were treated with definitive SSRS (44 [67%]) versus postoperatively (22 [33%]). The actuarial 1-year OS and LC rates were 67% and 81%, respectively. Eighteen patients had a local relapse, which was more significantly associated with postoperative SSRS (p = 0.04). On multivariate modeling, receipt of postoperative SSRS neared significance for poorer LC (p = 0.06, subhazard ratio [SHR] 2.33), while only 2 covariates emerged as significantly correlated with LC: 1) biological equivalent dose (BED) > 48 Gy (vs BED ≤ 48 Gy, p = 0.006, SHR 0.21) and 2) single vertebral body involvement (vs multiple bodies, p = 0.03, SHR 0.27). Of the 18 local recurrences, 14 (78%) occurred at the margin, and while the majority of these cases relapsed within the epidural space, 4 relapsed within the paraspinal soft tissue. In addition, 1 relapse occurred out of field. Finally, the most common acute toxicity was fatigue (15 cases), with few late toxicities (4 insufficiency fractures, 3 neuropathies). CONCLUSIONS For metastatic sarcomas, SSRS provides durable tumor control with minimal toxicity. High-dose single-fraction regimens offer optimal LC, and given the infiltrative nature of sarcomas, when paraspinal soft tissues are involved, larger treatment volumes may be warranted.
[Mh] MeSH terms primary: Radiosurgery
Sarcoma/pathology
Spinal Neoplasms/radiotherapy
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Radiosurgery/adverse effects
Recurrence
Treatment Failure
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170913
[Lr] Last revision date:170913
[Js] Journal subset:IM
[Da] Date of entry for processing:170624
[St] Status:MEDLINE
[do] DOI:10.3171/2017.1.SPINE161045


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