NEW YORK (Reuters Health) – Researchers from the Mayo Clinic have developed a risk-stratification tool to help predict vertebral compression fracture (VCF) following stereotactic body radiation therapy (SBRT) and potentially select patients for prophylactic or early spinal stabilization.
Reported rates of VCF after SBRT range from 15% to 40%, they note in JAMA Oncology.
To develop the risk score, Dr. Kenneth Merrell of Mayo Clinic Rochester and colleagues did a retrospective analysis of 331 patients who underwent 464 spine SBRT treatments.
They identified four key predictors of VCF – epidural tumor extension, lumbar location, gross tumor volume of more than 10 cc and a spinal instability neoplastic score of more than six – with one point assigned for each factor.
The hazard ratio for VCF per one-point increase was 1.93 (95% CI, 1.62 to 2.30).
At two years, the cumulative incidence of VCF for low-risk patients with a score of zero to one was 6.7%, and increased to 17.0% for intermediate-risk patients with a score of two, to 35.4% for high-risk cases with a score of three to four.
“This study is chiefly limited by the retrospective analysis of data from a single institution; however, a strength of the analysis was the large data set available for assessment,” Dr. Merrell and colleagues note.
“We strongly favor further assessment of the model via external or prospective validation; however, in the absence of such data, we would suggest considering the potential clinical use of this model to select for patients at high risk for developing VCF after treatment with spine SBRT,” they conclude.
The study had no specific funding.
SOURCE: https://bit.ly/3o9n6Gy JAMA Oncology, online January 27, 2022.
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