The NOMS Framework: Approach to the Treatment of Spinal Metastatic Tumors
Ilya Laufer,David G. Rubin,Eric Lis,Brett Cox,Michael D. Stubblefield,Yoshiya Yamada,Mark H. Bilsky +6 more
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TLDR
Application of the NOMS paradigm integrates multimodality therapy to optimize local tumor control, pain relief, and restoration or preservation of neurologic function and minimizes morbidity in this often systemically ill patient population.Abstract:
Background.
Spinal metastases frequently arise in patients with cancer. Modern oncology provides numerous treatment options that include effective systemic, radiation, and surgical options. We delineate and provide the evidence for the neurologic, oncologic, mechanical, and systemic (NOMS) decision framework, which is used at Memorial Sloan-Kettering Cancer Center to determine the optimal therapy for patients with spine metastases.read more
Citations
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Journal ArticleDOI
An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report
Daniel E. Spratt,Whitney H. Beeler,Fabio Y. Moraes,Laurence D. Rhines,Joseph J. Gemmete,Neeraj Chaudhary,David B. Shultz,Sean R. Smith,Alejandro Berlin,Max Dahele,Ben J. Slotman,Kelly C. Younge,Mark H. Bilsky,Paul Park,Nicholas J. Szerlip +14 more
TL;DR: The variables that should be considered during the management of patients with spinal metastases are discussed and the role of each discipline and their respective management options to provide optimal care are reviewed.
Journal ArticleDOI
The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery.
Yoshiya Yamada,Evangelia Katsoulakis,Ilya Laufer,Michael Lovelock,Ori Barzilai,Lily McLaughlin,Zhigang Zhang,Adam M. Schmitt,Daniel S. Higginson,Eric Lis,Michael J. Zelefsky,James Mechalakos,Mark H. Bilsky +12 more
TL;DR: High-dose single-session SRS provides durable long-term control, regardless of the histological findings or tumor size, suggesting that radioresistant histological types benefit in particular from radiosurgery.
Journal ArticleDOI
Outcomes and Toxicity for Hypofractionated and Single-Fraction Image-Guided Stereotactic Radiosurgery for Sarcomas Metastasizing to the Spine
Michael R. Folkert,Mark H. Bilsky,Ashlyn Tom,Jung Hun Oh,Kaled M. Alektiar,Ilya Laufer,William D. Tap,Yoshiya Yamada +7 more
TL;DR: In the largest series of metastatic sarcoma to the spine to date, IG-SRS provides excellent LC in the setting of an aggressive disease with low radiation sensitivity and poor prognosis.
Journal ArticleDOI
State of the Art Treatment of Spinal Metastatic Disease.
TL;DR: This review recapitulates the current state‐of‐the‐art, evidence‐based data on the treatment of spinal metastases, integrating these data into a decision framework, NOMS, which integrates the 4 sentinel decision points in metastatic spine tumors.
Journal ArticleDOI
Separation surgery for spinal metastases: effect of spinal radiosurgery on surgical treatment goals.
Nelson Moussazadeh,Nelson Moussazadeh,Ilya Laufer,Ilya Laufer,Yoshiya Yamada,Mark H. Bilsky,Mark H. Bilsky +6 more
TL;DR: The combination of separation surgery and high-dose hypofractionated or single-fraction SRS results in high local tumor control at 1 year and is an effective palliative paradigm for this patient population.
References
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Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial
Roy A. Patchell,Phillip A. Tibbs,William F. Regine,Richard Payne,Stephen Saris,Richard J. Kryscio,Mohammed Mohiuddin,Byron Young +7 more
TL;DR: Direct decompressive surgery plus postoperative radiotherapy is superior to treatment with radiotherapy alone for patients with spinal cord compression caused by metastatic cancer.
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TL;DR: It is concluded that RT without decompressive laminectomy is as effective as decompressive Laminectomy in treating epidural spinal cord compression from systemic cancer.
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A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group.
Charles G. Fisher,Christian P. DiPaola,Timothy C. Ryken,Mark H. Bilsky,Christopher I. Shaffrey,Sigurd Berven,James S. Harrop,Michael G. Fehlings,Stefano Boriani,Dean Chou,Meic H. Schmidt,David W. Polly,Roberto Biagini,Shane Burch,Mark B. Dekutoski,Aruna Ganju,Peter C. Gerszten,Ziya L. Gokaslan,Michael W. Groff,Norbert J. Liebsch,Ehud Mendel,Scott H. Okuno,Shreyaskumar Patel,Laurence D. Rhines,Peter S. Rose,Daniel M. Sciubba,Narayan Sundaresan,Katsuro Tomita,Péter Varga,Luiz Roberto Vialle,Frank D. Vrionis,Yoshiya Yamada,Daryl R. Fourney +32 more
TL;DR: The Spine Instability Neoplastic Score is a comprehensive classification system with content validity that can guide clinicians in identifying when patients with neoplastic disease of the spine may benefit from surgical consultation and aid surgeons in assessing the key components of spinal instability due to neoplasia.
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Palliative Radiotherapy Trials for Bone Metastases: A Systematic Review
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Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution.
TL;DR: The results indicate the potential of radiosurgery in the treatment of patients with spinal metastases, especially those with solitary sites of spine involvement, to improve long-term palliation.
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