Clinical Evaluation of the Spinal Instability Neoplastic Score in Patients Treated With Radiotherapy for Symptomatic Spinal Bone Metastases.

Abstract:

STUDY DESIGN:Retrospective cohort study. OBJECTIVE:To determine the predictive value of the Spinal Instability Neoplastic Score (SINS) in a cohort of patients treated with radiotherapy for spinal bone metastases. SUMMARY OF BACKGROUND DATA:Assessment of spinal stability in metastatic disease is challenging and is mostly done by relying on clinical experience, in the absence of validated guidelines or an established predetermined set of risk factors. The SINS provides clinicians with a tool to assess tumor-related spinal instability. METHODS:A total of 110 patients were included in this retrospective study. Time to event was calculated as the difference between start of radiotherapy and date of occurrence of an adverse event or last follow-up, with death being considered a competing event. A competing risk analysis was performed to estimate the effect of the SINS on the cumulative incidence of the occurrence of an adverse event. RESULTS:Sixteen patients (15%) experienced an adverse event during follow-up. The cumulative incidence for the occurrence of an adverse event at 6 and 12 months was 11.8% (95% confidence interval 5.1%-24.0%) and 14.5% (95% confidence interval 6.9%-22.2%), respectively. Competing risk analysis showed that the final SINS classification was not significantly associated with the cumulative incidence of an adverse event within the studied population. CONCLUSION:The clinical applicability of the SINS as a tool to assess spinal instability seems limited. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Bollen L,Groenen K,Pondaag W,van Rijswijk CSP,Fiocco M,Van der Linden YM,Dijkstra SPD

doi

10.1097/BRS.0000000000002058

subject

Has Abstract

pub_date

2017-08-15 00:00:00

pages

E956-E962

issue

16

eissn

0362-2436

issn

1528-1159

pii

00007632-201708150-00010

journal_volume

42

pub_type

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