Journal article
A systematic review of stereotactic radiosurgery for metastatic spinal sarcomas
Journal of neuro-oncology, v 172(1), pp 153-162
01 Mar 2025
PMID: 39607569
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose
Sarcomas metastasizing to the spine are a rare entity. Ideally an En-bloc resection is necessary to achieve durable local control (LC) rates. However, anatomical constraints often limit the degree of tumor resection. Because of this, other therapeutic modalities either replacing or as an adjuvant to resection are necessary. Stereotactic radiosurgery (SRS) is a reasonable candidate therapy.
Methods
We conducted a systematic review of the literature using the following databases: PubMed, Science Direct, and Cochrane library. We used a combination of the following terms connected by boolean operators: “Metastatic Sarcoma, Sarcoma of the Spine, Spine Sarcoma, Metastasis, stereotactic radiosurgery, SRS.” All retrospective and prospective cohorts, as well as randomized control trials reporting on patients with histopathologically confirmed metastatic sarcomas of the bony elements of the vertebrae, thecal sac, cord, or associated soft tissues of the spine were included. We excluded animal studies, case reports, case series, patients < 18 (pediatric cohorts), review articles and meta-analyses. No date filters were applied to our search.
Results
Our final analysis included 5 studies ranging from 2009 to 2024 reporting on 260 patients and 371 associated lesions. Leiomyosarcoma was the most frequently reported histologic subtype (60%). Most lesions were localized to the thoracic spine (48.6%). 75% of studies reported a median dose < 30 Gy, and achieved biologically equivalent doses (BEDs) ranging from < 50–100. Pooled 1-year median survival was 64.5% (IQR: 61.8–75.10). Pooled 1-year median LC was 86% (IQR: 79.4–88.5). Three of five studies (60%) for OS and 4/5 (80%) for LC had data availability suitable for meta-analysis. The 1-year OS and LC rates proportions across these studies were 67% (proportion = 0.67, 95% CI: 0.57–0.75, p = 0.07, I
2
= 63%), and 84% (proportion = 0.84, 95% CI: 0.78–0.89, p = 0.10, I
2
= 52%) respectively. Median follow up across all studies was 18 months (IQR:12.7–31.3).
Conclusions
SRS is a reasonable alternative therapy in either the up front, salvage or adjuvant setting which can facilitate durable LC.
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Details
- Title
- A systematic review of stereotactic radiosurgery for metastatic spinal sarcomas
- Creators
- Trent Kite - Allegheny Health NetworkStephen Jaffe - Allegheny Health NetworkVineetha Yadlapalli - Drexel UniversityRhea Verma - Drexel UniversityJenna Li - Allegheny-Singer Research InstituteStephen Karlovits - Allegheny Health NetworkRodney E. Wegner - Allegheny Health NetworkMatthew J. Shepard (Corresponding Author) - Allegheny Health Network
- Publication Details
- Journal of neuro-oncology, v 172(1), pp 153-162
- Publisher
- Springer Nature
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:001367204700001
- Scopus ID
- 2-s2.0-85210568141
- Other Identifier
- 991022155292204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Oncology