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Spinal Diseases: HELP
Articles by Melissa Funaro
Based on 1 article published since 2010
(Why 1 article?)

Between 2010 and 2020, Melissa Funaro wrote the following article about Spinal Diseases.
+ Citations + Abstracts
1 Guideline Stereotactic body radiotherapy for de novo spinal metastases: systematic review. 2017

Husain, Zain A / Sahgal, Arjun / De Salles, Antonio / Funaro, Melissa / Glover, Janis / Hayashi, Motohiro / Hiraoka, Masahiro / Levivier, Marc / Ma, Lijun / Martínez-Alvarez, Roberto / Paddick, J Ian / Régis, Jean / Slotman, Ben J / Ryu, Samuel. ·Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut. · Department of Radiation Oncology, University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada. · Department of Neurosurgery, University of California, Los Angeles, California. · Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut. · Department of Neurosurgery, Tokyo Women's Medical University, Tokyo. · Department of Radiation Oncology, Kyoto University, Kyoto, Japan. · Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. · Division of Physics, Department of Radiation Oncology, University of California, San Francisco, California. · Department of Neurosurgery, Ruber International Hospital, Madrid, Spain. · National Hospital for Neurology and Neurosurgery, London, United Kingdom. · Department of Functional Neurosurgery, Timone University Hospital, Aix-Marseille University, Marseille, France. · Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands; and. · Department of Radiation Oncology, Stony Brook University, Stony Brook, New York. ·J Neurosurg Spine · Pubmed #28598293.

ABSTRACT: OBJECTIVE The aim of this systematic review was to provide an objective summary of the published literature pertaining to the use of stereotactic body radiation therapy (SBRT) specific to previously untreated spinal metastases. METHODS The authors performed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of the literature found in a search of Medline, PubMed, Embase, and the Cochrane Library up to March 2015. The search strategy was limited to publications in the English language. RESULTS A total of 14 full-text articles were included in the analysis. All studies were retrospective except for 2 studies, which were prospective. A total of 1024 treated spinal lesions were analyzed. The median follow-up time ranged from 9 to 49 months. A range of dose-fractionation schemes was used, the most common of which were 16-24 Gy/1 fraction (fx), 24 Gy/2 fx, 24-27 Gy/3 fx, and 30-35 Gy/5 fx. In studies that reported crude results regarding in-field local tumor control, 346 (85%) of 407 lesions remained controlled. For studies that reported actuarial values, the weighted average revealed a 90% 1-year local control rate. Only 3 studies reported data on complete pain response, and the weighted average of these results yielded a complete pain response rate of 54%. The most common toxicity was new or progressing vertebral compression fracture, which was observed in 9.4% of cases; 2 cases (0.2%) of neurologic injury were reported. CONCLUSION There is a paucity of prospective data specific to SBRT in patients with spinal metastases not otherwise irradiated. This systematic review found that SBRT is associated with favorable rates of local control (approximately 90% at 1 year) and complete pain response (approximately 50%), and low rates of serious adverse events were found. Practice guidelines are summarized based on these data and International Stereotactic Radiosurgery Society consensus.