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Comparative Effectiveness of Kyphoplasty and Radiation with or Without Radiofrequency Ablation in Spinal Metastases from Lung Cancer
Journal article   Open access   Peer reviewed

Comparative Effectiveness of Kyphoplasty and Radiation with or Without Radiofrequency Ablation in Spinal Metastases from Lung Cancer

Kamal A Shaik, Spencer Thomas Rasmussen, Muhammad Hozien, Rudy Rahme and Michael Karsy
Healthcare, v 13(23), 3101
28 Nov 2025
DOI: https://doi.org/10.3390/healthcare13233101
PMID: 41373318
Featured in Collection :   Research Supported by Drexel Libraries' OA Programs
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https://doi.org/10.3390/healthcare13233101View
Published, Version of Record (VoR)Open Access Discount via Drexel Libraries Read and Publish Program 2025CC BY V4.0,  Open

Abstract

spinal metastases lung cancer kyphoplasty radiofrequency ablation radiotherapy TriNetX
Background/Objectives: Spinal metastases from lung cancer cause substantial pain, instability, and neurologic compromise. Radiotherapy and kyphoplasty are standard treatment modalities, while radiofrequency ablation (RFA) has emerged as a potential adjunct for cytoreduction. The objective of this study was to evaluate whether RFA confers additional benefit when combined with kyphoplasty and radiotherapy in patients with lung cancer spinal metastases. Methods: We conducted a retrospective cohort study of adults with lung cancer and spinal metastases from 2012–2024 using the TriNetX database. Patients were identified using International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes and stratified into two groups: kyphoplasty with radiotherapy alone versus kyphoplasty with radiotherapy and RFA. Propensity score matching was applied to balance demographic and clinical covariates. The primary outcome was 1-year all-cause mortality. Secondary outcomes included tumor recurrence, neurologic complications, and pain burden as assessed by opioid prescription rates. Risk ratios (RR) with 95% confidence intervals (CI) were calculated. Results: A total of 703 patients met inclusion criteria. After matching, no significant differences were observed between groups for 1-year mortality (RR 1.021, 95% CI 0.83–1.256), tumor recurrence (RR 0.989, 95% CI 0.789–1.238), neurologic complications (RR 1.052, 95% CI 0.563–1.967), or opioid use as a pain proxy (RR 0.986, 95% CI 0.76–1.28). Conclusions: The addition of RFA to kyphoplasty and radiotherapy did not significantly impact survival, recurrence, neurologic, or pain outcomes in patients with spinal metastases from lung cancer. These findings suggest that the incremental benefit of RFA in this setting is limited and emphasize the need for prospective studies to refine patient selection and treatment strategies.

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Collaboration types
Domestic collaboration
Web of Science research areas
Health Care Sciences & Services
Health Policy & Services
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