How many vertebral levels do you choose to treat with post-op RT?
There are many cases where patient has cord compression in 1-2 vertebral levels, but surgery was done with hardware encompassing 5-7 levels. Are you covering the entire extent of hardware and vertebral levels in this case? I understand the recent MSKCC study published suggesting to cover hardware reduces local failure, although this was in long bone metastases, not spinal.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Washington School of Medicine
Answered on
Based on my long term observation/experience and the data from the postop SBRT literature, there is no need to include the whole extent of the surgical hardware. I never did for postop RT or SBRT and never saw a recurrence outside of the involved segment +/- contiguous areas. The international postop SBRT consensus statement led by Dr. @Dr. First Last also concluded that it's not necessary to cover the whole surgical hardware.
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Mednet Member
Radiation Oncology · Physician Health Partners
Answered on
I tried to include the entire surgical area to prevent recurrence.
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