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Kyphoplasty and intra-operative radiotheray, combination of kyphoplasty and intra-operative radiation for spinal metastases: Technical feasibility of a novel approach

机译:后凸成形术和术中放射线照射,后凸成形术和术中放射线结合治疗脊柱转移瘤:一种新方法的技术可行性

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Purpose: To evaluate whether this new method is clinically applicable after theoretical and cadaver testing. Methods: The incidence of spinal metastases requiring therapy is increasing, due to enhanced life expectancy. Due to results from studies with epidural compression a combined surgical and radiation therapy is often chosen. Minimal invasive cement augmentation is an increasingly used technique, due to fast pain relief and immediate stabilisation. On the other hand, stereotactic radiosurgery is considered to provide a more durable response and better local disease control than conventional radiotherapy with the application of higher doses. Therefore the combination of cement stabilisation and simultaneous intra-operative radiation with immediate stabilisation and high-dose radiation could be an interesting therapeutic option. The results of a clinical feasibility study are presented. Results: 17 patients could be treated with the new method. In two patients (10%) intra-operative radiation could not be applied. No surgical interventions for complications were required. Conclusions: Summarizing Kypho-IORT is technically feasible with an intra-operative risk profile comparable to sole kyphoplasty and a shorter treatment time and hospitalisation for the patients compared to conventional multifraction radiation. Radiation could not be applied in 10% of cases due to technical difficulties. The results of this feasibility study permit further evaluation of this new technique by a dose escalation study which is currently in preparation.
机译:目的:在理论和尸体测试之后,评估这种新方法是否在临床上适用。方法:由于预期寿命的延长,需要治疗的脊柱转移瘤的发生率正在增加。由于硬膜外压迫研究的结果,通常选择外科手术和放射疗法的组合。由于快速的疼痛缓解和立即的稳定作用,微创骨水泥增强术是越来越多的使用技术。另一方面,立体定向放射手术被​​认为与常规放射疗法相比,具有更高的剂量,可以提供更持久的反应和更好的局部疾病控制。因此,将水泥稳定和术中同时放射与立即稳定和大剂量放射相结合可能是一种有趣的治疗选择。提出了临床可行性研究的结果。结果:17例患者可以接受新方法治疗。在两名患者(10%)中,无法进行术中放疗。无需手术干预即可获得并发症。结论:总结Kypho-IORT在技术上是可行的,与传统的多级放疗相比,术中的风险概况与单独的后凸成形术相当,并且患者的治疗时间和住院时间更短。由于技术困难,无法在10%的情况下应用辐射。该可行性研究的结果允许通过目前正在准备的剂量递增研究进一步评估这项新技术。

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