Terapi radiasi pada pasien dengan metastasis vertebrae dapat memberikan manfaat karena efeknya yang meringankan keluhan pada pasien. Metastasis vertebrae sendiri umumnya berasal dari tumor primer, seperti kanker payudara, kanker prostat, dan kanker paru.[1]
Metastasis vertebrae yang simptomatik menimbulkan rasa nyeri dan defisit neurologis. Rasa nyeri yang timbul disebabkan oleh beberapa mekanisme. Mekanisme tersebut berupa invasi dan ekspansi tumor yang meningkatkan tekanan pada periosteum. Selain itu, instabilitas tulang belakang yang disebabkan destruksi vertebrae, fraktur kompresi, atau kompresi neural juga menyebabkan munculnya gejala.[2,3]
Metastasis vertebrae juga dapat menimbulkan komplikasi lebih lanjut, seperti fraktur kompresi patologis vertebrae (pathologic vertebral compression fractures atau pVCF) dan metastasis kompresi epidural korda spinalis atau metastatic epidural spinal cord compression (MESCC).[1]
(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)
Referensi
1. Van den Brande R, et al. Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review. J Bone Oncol. 2022 Jul 9;35:100446. doi: 10.1016/j.jbo.2022.100446.
2. Shakil H, et al. Contemporary trends in the incidence and timing of spinal metastases: A population-based study. Neurooncol Adv. 2024 Apr 18;6(1):vdae051. doi: 10.1093/noajnl/vdae051.
3. Jaipanya P, Chanplakorn P. Spinal metastasis: narrative reviews of the current evidence and treatment modalities. J Int Med Res. 2022 Apr;50(4):3000605221091665. doi: 10.1177/03000605221091665.
4. Gottumukkala S, et al. Fundamentals of Radiation Oncology for Treatment of Vertebral Metastases. Radiographics. 2021 Nov-Dec;41(7):2136-2156. doi: 10.1148/rg.2021210052.
5. NICE. Spinal metastases and metastatic spinal cord compression. 2023. https://www.nice.org.uk/guidance/ng234/resources/spinal-metastases-and-metastatic-spinal-cord-compression-pdf-66143896133317
6. Alcorn S, et al. External Beam Radiation Therapy for Palliation of Symptomatic Bone Metastases: An ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2024 Sep-Oct;14(5):377-397. doi: 10.1016/j.prro.2024.04.018.
7. Guckenberger M, et al. ESTRO clinical practice guideline: Stereotactic body radiotherapy for spine metastases. Radiotherapy & Oncology (ESTRO). 2024. https://www.thegreenjournal.com/article/S0167-8140(23)89860-7/fulltext
8. Cassidy JT, Baker JF, Lenehan B. The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review. Global Spine Journal (Sage Journals). 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC6125937/
9. Skelly AC, et al. Radiation Therapy for Metastatic Bone Disease: Effectiveness and Harms. Agency for Healthcare Research and Quality. 2023. https://pubmed.ncbi.nlm.nih.gov/37851844/
10. Gabrar V, Richter S. Palliative Radiation Therapy For Bone Metastases. StatPearls Publishing. 2024. https://www.ncbi.nlm.nih.gov/books/NBK603757/
11. Westhoff PG, et al. Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique. J Radiat Oncol. 2017. https://pmc.ncbi.nlm.nih.gov/articles/PMC5856865/
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