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Increased Early Pain Relief by Adding Vertebroplasty to SBRT

Pain | Radiation Therapy | Spine Metastases

The goal of treating metastases is to preserve stability and neurological function while reducing pain. The actual standard of care is stereotaxic body radiation therapy (SBRT) alone in non-surgical patients. The added value of vertebroplasty to SBRT is not well documented in the literature, nor whether performing vertebroplasty before radiotherapy treatment leads to a reduction in the rate of fractures and post-SBRT pain.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    18 and up

Participation Criteria

Inclusion Criteria:

* Histological evidence of cancer.
* Spinal and vertebral bone metastases (T5 to L5) documented by imaging.
* Pain related to metastases ≥ 4 on a numerical scale 0-10.
* Karnofsky performance index \> 60 (ecog 0-2)
* Candidate for SBRT
* Less than 3 consecutive levels reached.
* Ability to complete follow-up questionnaires regarding pain, analgesics, and quality of life assessment.
* Potentially unstable lesions according to the spinal instability neoplastic score (SINS) scale (\> or = 7)

Exclusion Criteria:

* Pregnancy or breastfeeding.
* Contraindications to MRI.
* Histology: myeloma, lymphoma or plasmacytoma.
* Radiotherapy prior to the level to be treated.
* Previous surgery at the site to be treated.
* Surgical indication:

spinal instability neoplastic score (SINS) \> 13 or according to tumor board consensus.

Bilsky score \> or = 2 Severe or progressive neurological signs (motor, incontinence).

* Lesion too large for safe vertebroplasty.
* High thoracic location not allowing safe visibility in fluoroscopy to perform vertebroplasty (T4 and above).
* Non-reversible coagulation disorders.
* Uncontrolled local or systemic infection.
* Estimated survival of less than 6 months.
* Inability or refusal to undergo SBRT treatment or vertebroplasty

Study Location

Véronique Freire
Véronique Freire
Montréal, Quebec
Canada

Contact Study Team

Primary Contact

Véronique Freire, MD

CHUM
CHUM
Montréal, Quebec
Canada

Contact Study Team

Backup Contact

Mom PHAT

514 890-8000
Primary Contact

Veronique Freire, MD

[email protected]
514-883-6154
Study Sponsored By
Centre hospitalier de l'Université de Montréal (CHUM)
Participants Required
More Information
Study ID: NCT05317026