{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:04:39Z","timestamp":1790352279039,"version":"4.1.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Obtaining timely postoperative radiotherapy (RT) following separation surgery is critical to avoid local recurrence of disease yet can be a challenge due to scheduling conflicts, insurance denials, and travel arrangements. In patients undergoing metastatic spine surgery for spinal cord compression, the authors sought to: 1) report the rate of postoperative RT, 2) describe reasons for patients not receiving postoperative RT, and 3) investigate factors that may predict whether a patient receives postoperative RT.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A single-center retrospective case series was undertaken of all patients who underwent metastatic spine surgery for extradural disease between January 2010 and January 2021. Inclusion criteria were patients with intermediate or radioresistant tumors with evidence of spinal cord compression who underwent surgery. The primary outcome was the occurrence of RT within 3 months following surgery. Multivariable logistic regression analysis was performed controlling for age, BMI, race, total number of decompressed levels, tumor size, other organ metastasis, and preoperative RT or chemotherapy to predict patients receiving postoperative RT.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS <\/jats:title>\n<jats:p>Of 239 patients undergoing spine surgery for metastatic disease, 113 (47.3%) received postoperative RT while 126 (52.7%) did not. In the postoperative RT group, 24 (21.2%) received stereotactic body radiation therapy while 89 (78.8%) received conventional external-beam radiation therapy. The most common reasons for patients not receiving postoperative RT included death or transfer to hospice (31.0%), RT not being recommended by radiation oncology (30.2%), and loss to follow-up (23.8%). On critical review with the radiation oncology department, the authors estimated that 101 of 126 (80.2%) patients who did not receive postoperative RT were potential candidates for postoperative RT. Patients who received postoperative RT had more documented inpatient (48.7% vs 32.5%, p &lt; 0.001) and outpatient (100.0% vs 65.1%, p &lt; 0.001) radiation oncology consultations than those who did not. Additionally, patients who received postoperative RT had a higher rate of postoperative chemotherapy (53.1% vs 25.4%, p &lt; 0.001), while patients who did not receive postoperative RT had a higher rate of preoperative RT (7.1% vs 31.0%, p &lt; 0.001). Multivariable analysis confirmed that patients who received preoperative RT had lower odds of undergoing postoperative RT (OR 0.14, 95% CI 0.06\u20130.34; p &lt; 0.001), and patients who underwent postoperative chemotherapy had higher odds of undergoing postoperative RT (OR 3.83, 95% CI 2.05\u20137.17; p &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In the current study reflecting real-world care of patients with metastatic spine disease after undergoing separation surgery, 47% of patients did not receive postoperative RT, and 80% of those patients were potential candidates for postoperative RT. Radiation oncology consultation and postoperative chemotherapy were significantly associated with receiving postoperative RT, whereas preoperative RT was significantly associated with not receiving postoperative RT. The lack of timely postoperative RT highlights a potential gap in metastatic spine tumor care and underscores the necessity for prompt radiation oncology consultation and effective planning.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.spine231254","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T01:59:06Z","timestamp":1719626346000},"page":"416-427","source":"Crossref","is-referenced-by-count":7,"title":["Obstacles to receiving postoperative radiation therapy following separation surgery for metastatic spine disease"],"prefix":"10.3171","volume":"41","author":[{"given":"John E.","family":"Dugan","sequence":"first","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"College of Medicine, University of Tennessee Health Science Center, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor C.","family":"Long","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"James H. Quillen College of Medicine, East Tennessee State University, Johnson City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Chanbour","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel A.","family":"Bendfeldt","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Suryateja Gangavarapu","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyan","family":"Younus","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren","family":"Jonzzon","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Radiation Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo Y.","family":"Luo","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Radiation Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Berkman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian G.","family":"Lugo-Pico","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir M.","family":"Abtahi","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron F.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Spine Outcomes Lab, Nashville;"},{"name":"Departments of Neurological Surgery,"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Bone Oncol","first-page":"100450","article-title":"Separation surgery followed by stereotactic ablative radiotherapy for metastatic epidural spinal cord compression: a systematic review and meta-analysis for local progression rate","volume":"36","author":"Kang DH","year":"2022","unstructured":"Kang DH, Chang BS, Kim H, Hong SH, Chang SY. Separation surgery followed by stereotactic ablative radiotherapy for metastatic epidural spinal cord compression: a systematic review and meta-analysis for local progression rate. J Bone Oncol. 2022;36:100450."},{"issue":"suppl 1","key":"b2","series-title":"Neurooncol Pract","first-page":"i5","article-title":"Epidemiology of spinal cord and column tumors","volume":"7","author":"Wewel JT","year":"2020","unstructured":"Wewel JT, O\u2019Toole JE. Epidemiology of spinal cord and column tumors. Neurooncol Pract. 2020;7(suppl 1):i5-i9."},{"issue":"12","key":"b3","series-title":"Lancet Oncol","first-page":"e720","article-title":"An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report","volume":"18","author":"Spratt DE","year":"2017","unstructured":"Spratt DE, Beeler WH, de Moraes FY. An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report. Lancet Oncol. 2017;18(12):e720\u2013e730."},{"issue":"1","key":"b4","series-title":"J Neurosurg Sci","first-page":"37","article-title":"Stereotactic radiosurgery for metastatic spine tumors","volume":"58","author":"Chan NK","year":"2014","unstructured":"Chan NK, Abdullah KG, Lubelski D. Stereotactic radiosurgery for metastatic spine tumors. J Neurosurg Sci. 2014;58(1):37\u201344."},{"key":"b5","series-title":"Front Surg","first-page":"686930","article-title":"Comparison of surgical outcomes between separation surgery and piecemeal spondylectomy for spinal metastasis: a retrospective analysis","volume":"8","author":"Xu L","year":"2021","unstructured":"Xu L, Huang W, Cai W. Comparison of surgical outcomes between separation surgery and piecemeal spondylectomy for spinal metastasis: a retrospective analysis. Front Surg. 2021;8:686930."},{"key":"b6","series-title":"J Bone Oncol","first-page":"100320","article-title":"Separation surgery for metastatic epidural spinal cord compression: a qualitative review","volume":"25","author":"Di Perna G","year":"2020","unstructured":"Di Perna G, Cofano F, Mantovani C,  Separation surgery for metastatic epidural spinal cord compression: a qualitative review. J Bone Oncol. 2020;25:100320."},{"issue":"2","key":"b7","series-title":"Cancer Contr","first-page":"168","article-title":"Separation surgery for spinal metastases: effect of spinal radiosurgery on surgical treatment goals","volume":"21","author":"Moussazadeh N","year":"2014","unstructured":"Moussazadeh N, Laufer I, Yamada Y, Bilsky MH. Separation surgery for spinal metastases: effect of spinal radiosurgery on surgical treatment goals. Cancer Contr. 2014;21(2):168\u2013174."},{"issue":"7","key":"b8","series-title":"Spine J","first-page":"1109","article-title":"Predictors of quality of life improvement after surgery for metastatic tumors of the spine: prospective cohort study","volume":"18","author":"Barzilai O","year":"2018","unstructured":"Barzilai O, McLaughlin L, Amato MK,  Predictors of quality of life improvement after surgery for metastatic tumors of the spine: prospective cohort study. Spine J. 2018;18(7):1109\u20131115."},{"issue":"1","key":"b9","series-title":"Radiat Oncol","first-page":"21","article-title":"Delayed postoperative radiotherapy increases the incidence of radiographic local tumor progression before radiotherapy and leads to poor prognosis in spinal metastases","volume":"16","author":"Gong Y","year":"2021","unstructured":"Gong Y, Zhuang H, Chong S,  Delayed postoperative radiotherapy increases the incidence of radiographic local tumor progression before radiotherapy and leads to poor prognosis in spinal metastases. Radiat Oncol. 2021;16(1):21."},{"key":"b10","series-title":"World Neurosurg","first-page":"e76","article-title":"Local tumor control for metastatic epidural spinal cord compression following separation surgery with adjuvant CyberKnife stereotactic radiotherapy or image-guided intensity-modulated radiotherapy","volume":"141","author":"Hu JX","year":"2020","unstructured":"Hu JX, Gong YN, Jiang XD,  Local tumor control for metastatic epidural spinal cord compression following separation surgery with adjuvant CyberKnife stereotactic radiotherapy or image-guided intensity-modulated radiotherapy. World Neurosurg. 2020;141:e76\u2013e85."},{"issue":"1","key":"b11","series-title":"Int J Radiat Oncol Biol Phys","first-page":"106","article-title":"Phase 2 clinical trial of separation surgery followed by stereotactic body radiation therapy for metastatic epidural spinal cord compression","volume":"112","author":"Ito K","year":"2022","unstructured":"Ito K, Sugita S, Nakajima Y. Phase 2 clinical trial of separation surgery followed by stereotactic body radiation therapy for metastatic epidural spinal cord compression. Int J Radiat Oncol Biol Phys. 2022;112(1):106\u2013113."},{"issue":"3","key":"b12","series-title":"J Neurosurg Spine","first-page":"332","article-title":"Postoperative re-irradiation using stereotactic body radiotherapy for metastatic epidural spinal cord compression","volume":"29","author":"Ito K","year":"2018","unstructured":"Ito K, Nihei K, Shimizuguchi T. Postoperative re-irradiation using stereotactic body radiotherapy for metastatic epidural spinal cord compression. J Neurosurg Spine. 2018;29(3):332\u2013338."},{"issue":"3","key":"b13","series-title":"J Neurosurg Spine","first-page":"299","article-title":"Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey","volume":"26","author":"Redmond KJ","year":"2017","unstructured":"Redmond KJ, Lo SS, Soltys SG. Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey. J Neurosurg Spine. 2017;26(3):299\u2013306."},{"issue":"5","key":"b14","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Factors associated with adjacent-level tumor progression in patients receiving surgery followed by radiosurgery for metastatic epidural spinal cord compression","volume":"50","author":"Chakravarthy VB","year":"2021","unstructured":"Chakravarthy VB, Khan HA, Srivatsa S, Emch T, Chao ST, Krishnaney AA. Factors associated with adjacent-level tumor progression in patients receiving surgery followed by radiosurgery for metastatic epidural spinal cord compression. Neurosurg Focus. 2021;50(5):E15."},{"issue":"5","key":"b15","series-title":"Asian Spine J","first-page":"799","article-title":"An updated review on the treatment strategy for spinal metastasis from the spine surgeon\u2019s perspective","volume":"16","author":"Hong SH","year":"2022","unstructured":"Hong SH, Chang BS, Kim H, Kang DH, Chang SY. An updated review on the treatment strategy for spinal metastasis from the spine surgeon\u2019s perspective. Asian Spine J. 2022;16(5):799\u2013811."},{"issue":"9486","key":"b16","series-title":"Lancet","first-page":"643","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"Patchell RA","year":"2005","unstructured":"Patchell RA, Tibbs PA, Regine WF. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366(9486):643\u2013648."},{"issue":"4","key":"b17","series-title":"J Neurosurg Spine","first-page":"409","article-title":"Stereotactic radiosurgery for spinal metastases with or without separation surgery","volume":"22","author":"Bate BG","year":"2015","unstructured":"Bate BG, Khan NR, Kimball BY, Gabrick K, Weaver J. Stereotactic radiosurgery for spinal metastases with or without separation surgery. J Neurosurg Spine. 2015;22(4):409\u2013415."},{"issue":"3","key":"b18","series-title":"J Neurosurg Spine","first-page":"207","article-title":"Local disease control for spinal metastases following \"separation surgery\" and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients","volume":"18","author":"Laufer I","year":"2013","unstructured":"Laufer I, Iorgulescu JB, Chapman T. Local disease control for spinal metastases following \"separation surgery\" and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients. J Neurosurg Spine. 2013;18(3):207\u2013214."},{"issue":"1","key":"b19","series-title":"J Neurosurg Spine","first-page":"87","article-title":"Local disease control after decompressive surgery and adjuvant high-dose single-fraction radiosurgery for spine metastases","volume":"13","author":"Moulding HD","year":"2010","unstructured":"Moulding HD, Elder JB, Lis E. Local disease control after decompressive surgery and adjuvant high-dose single-fraction radiosurgery for spine metastases. J Neurosurg Spine. 2010;13(1):87\u201393."},{"issue":"2","key":"b20","series-title":"Int J Radiat Oncol Biol Phys","first-page":"261","article-title":"A phase 2 study of post-operative stereotactic body radiation therapy (SBRT) for solid tumor spine metastases","volume":"106","author":"Redmond KJ","year":"2020","unstructured":"Redmond KJ, Sciubba D, Khan M,  A phase 2 study of post-operative stereotactic body radiation therapy (SBRT) for solid tumor spine metastases. Int J Radiat Oncol Biol Phys. 2020;106(2):261\u2013268."},{"issue":"5","key":"b21","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1405","article-title":"Stereotactic body radiation therapy for spinal metastases in the postoperative setting: a secondary analysis of mature phase 1-2 trials","volume":"95","author":"Tao R","year":"2016","unstructured":"Tao R, Bishop AJ, Brownlee Z. Stereotactic body radiation therapy for spinal metastases in the postoperative setting: a secondary analysis of mature phase 1-2 trials. Int J Radiat Oncol Biol Phys. 2016;95(5):1405\u20131413."},{"issue":"12","key":"b22","series-title":"JCO Oncol Pract","first-page":"e1417","article-title":"Barriers to the delivery of timely, guideline-adherent adjuvant therapy among patients with head and neck cancer","volume":"16","author":"Graboyes EM","year":"2020","unstructured":"Graboyes EM, Halbert CH, Li H. Barriers to the delivery of timely, guideline-adherent adjuvant therapy among patients with head and neck cancer. JCO Oncol Pract. 2020;16(12):e1417\u2013e1432."},{"issue":"12","key":"b23","series-title":"JAMA Otolaryngol Head Neck Surg","first-page":"1105","article-title":"Association of care processes with timely, equitable postoperative radiotherapy in patients with surgically treated head and neck squamous cell carcinoma","volume":"144","author":"Janz TA","year":"2018","unstructured":"Janz TA, Kim J, Hill EG,  Association of care processes with timely, equitable postoperative radiotherapy in patients with surgically treated head and neck squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1105\u20131114."},{"issue":"14","key":"b24","series-title":"Cancer","first-page":"2651","article-title":"Adherence to National Comprehensive Cancer Network guidelines for time to initiation of postoperative radiation therapy for patients with head and neck cancer","volume":"123","author":"Graboyes EM","year":"2017","unstructured":"Graboyes EM, Garrett-Mayer E, Sharma AK, Lentsch EJ, Day TA. Adherence to National Comprehensive Cancer Network guidelines for time to initiation of postoperative radiation therapy for patients with head and neck cancer. Cancer. 2017;123(14):2651\u20132660."},{"issue":"2","key":"b25","series-title":"Orthop Surg","first-page":"404","article-title":"Efficacy analysis of separation surgery combined with SBRT for spinal metastases-a long-term follow-up study based on patients with spinal metastatic tumor in a single-center","volume":"12","author":"Xiaozhou L","year":"2020","unstructured":"Xiaozhou L, Xing Z, Xin S. Efficacy analysis of separation surgery combined with SBRT for spinal metastases-a long-term follow-up study based on patients with spinal metastatic tumor in a single-center. Orthop Surg. 2020;12(2):404\u2013420."},{"issue":"suppl 20","key":"b26","series-title":"Spine (Phila Pa 1976)","first-page":"S246","article-title":"When less is more: the indications for MIS techniques and separation surgery in metastatic spine disease","volume":"41","author":"Zuckerman SL","year":"2016","unstructured":"Zuckerman SL, Laufer I, Sahgal A. When less is more: the indications for MIS techniques and separation surgery in metastatic spine disease. Spine (Phila Pa 1976). 2016;41(suppl 20):S246-S253."},{"key":"b27","series-title":"Technol Cancer Res Treat","first-page":"15330338221107208","article-title":"Separation surgery in the treatment of spinal metastasis","volume":"21","author":"Li RF","year":"2022","unstructured":"Li RF, Qiao RQ, Xu MY, Ma RX, Hu YC. Separation surgery in the treatment of spinal metastasis. Technol Cancer Res Treat. 2022;21:15330338221107208."},{"key":"b28","series-title":"Neurosurg Rev","first-page":"351","article-title":"Transpedicular 3D endoscope-assisted thoracic corpectomy for separation surgery in spinal metastases: feasibility of the technique and preliminary results of a promising experience","volume":"43","author":"Cofano F","year":"2020","unstructured":"Cofano F, Di Perna G, Marengo N. Transpedicular 3D endoscope-assisted thoracic corpectomy for separation surgery in spinal metastases: feasibility of the technique and preliminary results of a promising experience. Neurosurg Rev. 2020;43:351\u2013360."},{"issue":"5","key":"b29","series-title":"Orthop Traumatol Surg Res","first-page":"589","article-title":"Retrospective multicenter study by the French Spine Society of surgical treatment for spinal metastasis in France","volume":"104","author":"Sailhan F","year":"2018","unstructured":"Sailhan F, Prost S, Zairi F. Retrospective multicenter study by the French Spine Society of surgical treatment for spinal metastasis in France. Orthop Traumatol Surg Res. 2018;104(5):589\u2013595."},{"issue":"2","key":"b30","series-title":"Neurosurgery","first-page":"303","article-title":"Metastatic spine disease: should patients with short life expectancy be denied surgical care? An international retrospective cohort study","volume":"87","author":"Dea N","year":"2020","unstructured":"Dea N, Versteeg AL, Sahgal A. Metastatic spine disease: should patients with short life expectancy be denied surgical care? An international retrospective cohort study. Neurosurgery. 2020;87(2):303\u2013311."},{"issue":"19","key":"b31","series-title":"N Engl J Med","first-page":"1937","article-title":"Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck","volume":"350","author":"Cooper JS","year":"2004","unstructured":"Cooper JS, Pajak TF, Forastiere AA. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med. 2004;350(19):1937\u20131944."},{"issue":"3","key":"b32","series-title":"Expert Rev Anticancer Ther","first-page":"293","article-title":"Concurrent chemotherapy and radiotherapy for head and neck cancer","volume":"9","author":"Burri RJ","year":"2009","unstructured":"Burri RJ, Lee NY. Concurrent chemotherapy and radiotherapy for head and neck cancer. Expert Rev Anticancer Ther. 2009;9(3):293\u2013302."},{"issue":"4","key":"b33","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1161","article-title":"Concurrent chemotherapy and reduced-dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average-risk medulloblastoma: efficacy and patterns of failure","volume":"58","author":"Douglas JG","year":"2004","unstructured":"Douglas JG, Barker JL, Ellenbogen RG, Geyer JR. Concurrent chemotherapy and reduced-dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average-risk medulloblastoma: efficacy and patterns of failure. Int J Radiat Oncol Biol Phys. 2004;58(4):1161\u20131164."},{"issue":"4","key":"b34","series-title":"Can J Surg","first-page":"E512","article-title":"Survival after surgery for spinal metastases: a population-based study","volume":"65","author":"Bhanot K","year":"2022","unstructured":"Bhanot K, Widdifield J, Huang A, Paterson JM, Shultz DB, Finkelstein J. Survival after surgery for spinal metastases: a population-based study. Can J Surg. 2022;65(4):E512\u2013E518."},{"issue":"1","key":"b35","series-title":"J Am Acad Orthop Surg","first-page":"37","article-title":"Metastatic disease in the thoracic and lumbar spine: evaluation and management","volume":"19","author":"Rose PS","year":"2011","unstructured":"Rose PS, Buchowski JM. Metastatic disease in the thoracic and lumbar spine: evaluation and management. J Am Acad Orthop Surg. 2011;19(1):37\u201348."},{"issue":"10","key":"b36","series-title":"Ann Transl Med","first-page":"216","article-title":"Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS","volume":"7","author":"Yahanda AT","year":"2019","unstructured":"Yahanda AT, Buchowski JM, Wegner AM. Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS. Ann Transl Med. 2019;7(10):216."},{"issue":"4","key":"b37","series-title":"Neurospine","first-page":"978","article-title":"Spinal metastases and the evolving role of molecular targeted therapy, chemotherapy, and immunotherapy","volume":"19","author":"Fomchenko EI","year":"2022","unstructured":"Fomchenko EI, Bayley JC, Alvarez-Breckenridge C, Rhines LD, Tatsui CE. Spinal metastases and the evolving role of molecular targeted therapy, chemotherapy, and immunotherapy. Neurospine. 2022;19(4):978\u2013993."},{"issue":"2","key":"b38","series-title":"Spine (Phila Pa 1976).","first-page":"193","article-title":"Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution","volume":"32","author":"Gerszten PC","year":"2007","unstructured":"Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine (Phila Pa 1976).2007;32(2):193\u2013199."},{"issue":"6","key":"b39","series-title":"Laryngoscope Investig Otolaryngol","first-page":"1358","article-title":"An equity-based narrative review of barriers to timely postoperative radiation therapy for patients with head and neck squamous cell carcinoma","volume":"6","author":"Noyes EA","year":"2021","unstructured":"Noyes EA, Burks CA, Larson AR, Deschler DG. An equity-based narrative review of barriers to timely postoperative radiation therapy for patients with head and neck squamous cell carcinoma. Laryngoscope Investig Otolaryngol. 2021;6(6):1358\u20131366."},{"issue":"4","key":"b40","series-title":"Int J Radiat Oncol Biol Phys","first-page":"923","article-title":"Trends in radiation therapy for bone metastases, 2015 to 2017: choosing wisely in the era of complex radiation","volume":"109","author":"Santos PMG","year":"2021","unstructured":"Santos PMG, Lapen K, Zhang Z. Trends in radiation therapy for bone metastases, 2015 to 2017: choosing wisely in the era of complex radiation. Int J Radiat Oncol Biol Phys. 2021;109(4):923\u2013931."},{"issue":"2","key":"b41","series-title":"JAMA Netw Open","first-page":"e1920471","article-title":"Trends in the use of stereotactic body radiotherapy for treatment of prostate cancer in the United States","volume":"3","author":"Mahase SS","year":"2020","unstructured":"Mahase SS, D\u2019Angelo D, Kang J, Hu JC, Barbieri CE, Nagar H. Trends in the use of stereotactic body radiotherapy for treatment of prostate cancer in the United States. JAMA Netw Open. 2020;3(2):e1920471."},{"issue":"7","key":"b42","series-title":"Radiographics","first-page":"2136","article-title":"Fundamentals of radiation oncology for treatment of vertebral metastases","volume":"41","author":"Gottumukkala S","year":"2021","unstructured":"Gottumukkala S, Srivastava U, Brocklehurst S. Fundamentals of radiation oncology for treatment of vertebral metastases. Radiographics. 2021;41(7):2136\u20132156."},{"issue":"9","key":"b43","series-title":"Spine J","first-page":"1414","article-title":"Spinal metastases 2021: a review of the current state of the art and future directions","volume":"21","author":"Sciubba DM","year":"2021","unstructured":"Sciubba DM, Pennington Z, Colman MW. Spinal metastases 2021: a review of the current state of the art and future directions. Spine J. 2021;21(9):1414\u20131429."},{"issue":"7","key":"b44","series-title":"Lancet Oncol","first-page":"1023","article-title":"Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2\/3 trial","volume":"22","author":"Sahgal A","year":"2021","unstructured":"Sahgal A, Myrehaug SD, Siva S. Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2\/3 trial. Lancet Oncol. 2021;22(7):1023\u20131033."},{"issue":"2","key":"b45","series-title":"Int J Radiat Oncol Biol Phys","first-page":"293","article-title":"Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy","volume":"114","author":"Zeng KL","year":"2022","unstructured":"Zeng KL, Myrehaug S, Soliman H. Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy. Int J Radiat Oncol Biol Phys. 2022;114(2):293\u2013300."},{"issue":"2","key":"b46","series-title":"J Palliat Care","first-page":"130","article-title":"Disparities in patterns of conventional versus stereotactic body radiotherapy in the treatment of spine metastasis in the United States","volume":"36","author":"Kim E","year":"2021","unstructured":"Kim E, McClelland S III, Jaboin JJ, Attia A. Disparities in patterns of conventional versus stereotactic body radiotherapy in the treatment of spine metastasis in the United States. J Palliat Care. 2021;36(2):130\u2013134."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/3\/article-p416.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/3\/article-p416.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/3\/article-p416.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:18:42Z","timestamp":1733491122000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/3\/article-p416.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":46,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2024.4.spine231254","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}