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DOI: 10.1055/s-0045-1810030
Advances in Radiotherapy in the Treatment of Metastatic Spinal Lesions
O avanço da radioterapia no tratamento das lesões metastáticas da colunaFinancial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.
Abstract
Metastatic spinal disease has become increasingly common due to advances in systemic oncological therapies and the increase in the overall survival of cancer patients. Its treatment is palliative, but the meaning of this term has evolved and, today, consists of better and more effective condition control over longer periods. In the past, surgical and radiotherapy techniques, especially conventional external beam radiation therapy (cEBRT), were ineffective or morbid for controlling many types of tumors. Now, the emergence and advancement of stereotactic body radiation therapy (SBRT) drastically changed this scenario. Surgery for managing metastatic disease remains significant in radiotherapy-associated strategies, but its purpose and technique have undergone major updates. However, despite all technical advances, radiotherapy has toxicity and side effects that warrant consideration. In this article, we provide an updated review covering everything from history to innovations in treating spinal metastases, focusing on their benefits, indications, and clinical impact.
Resumo
A doença metastática da coluna vertebral tem se tornado cada vez mais comum por conta do avanço das terapias sistêmicas oncológicas e do aumento na sobrevida geral dos pacientes com câncer. O tratamento dessa enfermidade é paliativo, mas a própria acepção deste termo evoluiu e hoje consiste em um melhor e mais efetivo controle da doença por períodos mais longos. Enquanto no passado as técnicas cirúrgicas e radioterápicas, principalmente a radioterapia convencional por feixe externo (cEBRT, do inglês conventional external beam radiation therapy), eram ineficazes ou mórbidas para o controle de muitos tipos de tumores, hoje, com o surgimento e avanço da radiocirurgia estereotáxica corporal (SBRT, do inglês stereotactic body radiation therapy), esse cenário mudou drasticamente. A cirurgia para o manejo da doença metastática ainda tem lugar em estratégias associadas com a radioterapia, mas sofreu grande atualização de propósito e técnica. Todavia, apesar de todo o avanço técnico, a radioterapia apresenta toxicidade e efeitos colaterais que precisam ser considerados. Neste artigo, fornecemos revisão atualizada que versa desde o histórico até as inovações no tratamento das metástases vertebrais, com foco em seus benefícios, indicações e impacto clínico.
Authors' Contributions
Each author contributed individually and significantly to the development of this article: BGMMC: conceptualization, idealization, methodology development and application, writing – original draft, and writing – review & editing; ARNSS, CBS, and MSM: writing – original draft and writing – review & editing; CCNF: methodology development and application, writing – original draft, and writing – review & editing; and AFC: conceptualization, idealization, and writing – review & editing.
Publication History
Received: 05 February 2025
Accepted: 26 April 2025
Article published online:
18 August 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Brian Guilherme Monteiro Marta Coimbra, Alice Roxo Nobre de Souza e Silva, Cauã Bhering Soares, Caio César Nogueira de Figueiredo, Manuel Salvado Macamo, Alexandre Fogaça Cristante. Advances in Radiotherapy in the Treatment of Metastatic Spinal Lesions. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451810030.
DOI: 10.1055/s-0045-1810030
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