- 作者：Gunita Mitera M.B.A.&lowast ; ; ; Gunita.Mitera@Sunnybrook.ca ; Linda Probyn M.D.&dagger ; ; Michael Ford M.D.&Dagger ; ; Andrea Donovan M.D.&dagger ; ; Joel Rubenstein M.D.&dagger ; ; Joel Finkelstein M.D.&Dagger ; ; Monique Christakis M.D.&dagger ; ; Liying Zhang Ph.D.&lowast ; ; Sarah Campos B.Sc.(C)&lowast ; ; Shaelyn Culleton B.Sc.(C)&lowast ; ; Janet Nguyen B.Sc.(C)&lowast ; ; Arjun Sahgal M.D.&lowast ; ; Elizabeth Barnes M.D.&lowast ; ; May Tsao M.D.&lowast ; ; Cyril Danjoux M.D.&lowast ; ; Lori Holden B.Sc.&lowast ; ; Albert Yee M.D.&Dagger ; ; Luluel Khan M.D.&lowast ; ; Edward Chow M.D.&lowast ;
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2011
- 出版时间：1 November 2011
- 年：2011
- 卷：81
- 期：3
- 页码：827-830
- 全文大小：225 K
Purpose
To correlate computed tomography (CT) imaging features of spinal metastases with pain relief after radiotherapy (RT).Methods and Materials
Thirty-three patients receiving computed tomography (CT)-simulated RT for spinal metastases in an outpatient palliative RT clinic from January 2007 to October 2008 were retrospectively reviewed. Forty spinal metastases were evaluated. Pain response was rated using the International Bone Metastases Consensus Working Party endpoints. Three musculoskeletal radiologists and two orthopaedic surgeons evaluated CT features, including osseous and soft tissue tumor extent, presence of a pathologic fracture, severity of vertebral height loss, and presence of kyphosis.
Results
The mean patient age was 69 years; 24 were men and 9 were women. The mean worst pain score was 7/10, and the mean total daily oral morphine equivalent was 77.3 mg. Treatment doses included 8 Gy in one fraction (22/33), 20 Gy in five fractions (10/33), and 20 Gy in eight fractions (1/33). The CT imaging appearance of spinal metastases included vertebral body involvement (40/40), pedicle involvement (23/40), and lamina involvement (18/40). Soft tissue component (10/40) and nerve root compression (9/40) were less common. Pathologic fractures existed in 11/40 lesions, with resultant vertebral body height loss in 10/40 and kyphosis in 2/40 lesions. At months 1, 2, and 3 after RT, 18 % , 69 % , and 70 % of patients experienced pain relief. Pain response was observed with various CT imaging features.
Conclusions
Pain response after RT did not differ in patients with and without pathologic fracture, kyphosis, or any other CT features related to extent of tumor involvement. All patients with painful spinal metastases may benefit from palliative RT.