Long Term Clinical Outcomes of Patients with Colorectal Cancer with Metastatic Epidural Spinal Cord Compression treated with Hybrid Therapy (Surgery followed by Stereotactic Body Radiation Therapy)

World Neurosurg, 2023 · DOI: 10.1016/j.wneu.2022.10.053 · Published: January 1, 2023

Simple Explanation

This study investigates the effectiveness of a combined treatment approach, called 'hybrid-therapy,' for patients with colorectal cancer (CRC) that has spread to the spine, causing compression of the spinal cord. Hybrid therapy involves surgery to relieve pressure on the spinal cord, followed by stereotactic body radiation therapy (SBRT) to target the tumor with high doses of radiation. The research aims to determine how well this hybrid therapy works in controlling the tumor and improving the outcomes for CRC patients with spinal cord compression.

Study Duration

2005-2020

Participants

50 adult patients with CRC spinal metastasis

Evidence Level

Retrospective study

Key Findings

1
Hybrid-therapy in CRC patients resulted in 86.7% local control at two years after surgery, with limited complications.
2
APC mutations are commonly present in CRC patients with spine metastases and may suggest worse prognosis.
3
Patients with CRC spinal metastases commonly progress outside the index treatment level.

Research Summary

This study evaluates the outcomes of hybrid therapy (separation surgery followed by SBRT) for colorectal cancer (CRC) patients with metastatic epidural spinal cord compression (MESCC). The results show that hybrid therapy leads to sustained local control with limited complications, but progression outside the treated area is common. The authors also found that APC mutations are common in these patients and may indicate a worse prognosis, emphasizing the importance of close monitoring for disease progression.

Practical Implications

Treatment Strategy

Hybrid therapy (separation surgery followed by SBRT) is an effective treatment for CRC patients presenting with MESCC, providing sustained local control.

Prognostic Marker

APC mutations may serve as a prognostic marker for worse outcomes in CRC patients with spinal metastases, warranting closer monitoring.

Follow-up Care

Close clinical and radiographic follow-up is essential for early detection of disease progression outside the treatment area, enabling timely intervention.

Study Limitations

1
Retrospective nature of the study
2
Limited number of patients restricting in-depth statistical analysis of local failure
3
Heterogenous systemic treatments received due to the advent of novel therapies over the years

Your Feedback

Was this summary helpful?

Back to Oncology