Evidence map›Paper›PMID 39381627›Full record

ArticleClinical and translational radiation oncology2024

Temporary halo fixation and radiotherapy as alternative to long-construct spondylodesis in patients with multiple unstable cervical metastases.

E H Huele, J M van der Velden, H M Verkooijen, N Kasperts, J J Verlaan

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Article in Clinical and translational radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

E H HueleDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
J M van der VeldenDepartment of Radiotherapy, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
H M VerkooijenDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
N KaspertsDepartment of Radiotherapy, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
J J VerlaanDepartment of Radiotherapy, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: Currently no minimally invasive surgical treatment exists to provide immediate stability for unstable cervical/cervicothoracic metastases. Long-construct spondylodesis carries a high complication risk and has severe impact on residual range of motion. This study explores temporary halo fixation and radiotherapy as an alternative to long-construct cervical spondylodesis. Materials and methods: This retrospective cohort study included twenty patients with multiple unstable cervical metastases treated between 2013-2023. All patients underwent halo fixation for an intended duration of three months to allow for safe reossification of lytic lesions following radiotherapy, with a dose fractionation scheme best suited to the histological origin of the tumor. Results: Immobilization with halo fixation lasted a median 83 days (range, 41-132 days). Radiotherapy started on average 7 days after halo fixation (range, -35-118 days). The median pain score at baseline was 8, and was 0 at halo removal and at last follow-up. All patients had no or minor neurological deficits at baseline and did not develop new neurological deficits. At halo removal, 17/18 patients showed radiographic evidence of reossification. The majority of patients experienced minor limitations or had full range of motion of the neck at last follow-up. Conclusion: Patients with multiple unstable cervical metastases treated with halo fixation and radiotherapy showed complete pain response or substantial pain reduction, reossification of the vertebrae and a, mostly, preserved range of motion. In selected neurologically intact patients, this treatment might be a patient-friendly alternative to fixation. Prospective evaluation of this treatment combination is needed.

Indexed as

Cervical spinal metastasesHalo fixationPalliationRadiotherapyRange of motionReossificationSpinal instabilitySpondylodesis

Identifiers

PMID39381627
PMCPMC11458975

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.