TY - JOUR
T1 - Benign tumors of the spine
T2 - Has new chemotherapy and interventional radiology changed the treatment paradigm?
AU - Charest-Morin, Raphaële
AU - Boriani, Stefano
AU - Fisher, Charles G.
AU - Patel, Shreyaskumar R.
AU - Kawahara, Norio
AU - Mendel, Ehud
AU - Bettegowda, Chetan
AU - Rhines, Laurence D.
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/10/15
Y1 - 2016/10/15
N2 - Objective. To determine the role of (A) medical treatment and (B) interventional radiology as either adjuvant or stand-alone treatment in primary benign bone tumors of the spine. Methods. A multidisciplinary panel of spine surgeons, radiation oncologists, and medical oncologists elaborated specific focused questions regarding aneurysmal bone cyst, giant cell tumor, and osteoid osteoma. Denosumab, bisphosphonate, interferon, bone marrow aspirate, doxycycline, thermal ablation, and selective arterial embolization were identified as areas of interest for the article. A systematic review was performed through MEDLINE and EMBASE. Recommendations based on the literature review and clinical expertise were issued using the GRADE system. Results. The overall quality of the literature is very low with few multicenter prospective studies. For giant cell tumor, combination with Denosumab identified 14 pertinent articles with four multicenter prospective studies. Nine studies were found on bisphosphonates and six for selective arterial embolization. The search on aneurysmal bone cyst and selective arterial embolization revealed 12 articles. Combination with Denosumab, Doxycycline, and bone marrow aspirate identified four, two, and three relevant articles respectively. Eleven focused articles were selected on the role of thermal ablation in osteoid osteoma. Conclusion. Alternative and adjuvant therapy for primary benign bone tumors have emerged. Their ability to complement or replace surgery is now being scrutinized and they may impact significantly the algorithm of treatment of these tumors. Most of the data are still emerging and further research is desirable. Close collaboration between the different specialists managing these pathologies is crucial.
AB - Objective. To determine the role of (A) medical treatment and (B) interventional radiology as either adjuvant or stand-alone treatment in primary benign bone tumors of the spine. Methods. A multidisciplinary panel of spine surgeons, radiation oncologists, and medical oncologists elaborated specific focused questions regarding aneurysmal bone cyst, giant cell tumor, and osteoid osteoma. Denosumab, bisphosphonate, interferon, bone marrow aspirate, doxycycline, thermal ablation, and selective arterial embolization were identified as areas of interest for the article. A systematic review was performed through MEDLINE and EMBASE. Recommendations based on the literature review and clinical expertise were issued using the GRADE system. Results. The overall quality of the literature is very low with few multicenter prospective studies. For giant cell tumor, combination with Denosumab identified 14 pertinent articles with four multicenter prospective studies. Nine studies were found on bisphosphonates and six for selective arterial embolization. The search on aneurysmal bone cyst and selective arterial embolization revealed 12 articles. Combination with Denosumab, Doxycycline, and bone marrow aspirate identified four, two, and three relevant articles respectively. Eleven focused articles were selected on the role of thermal ablation in osteoid osteoma. Conclusion. Alternative and adjuvant therapy for primary benign bone tumors have emerged. Their ability to complement or replace surgery is now being scrutinized and they may impact significantly the algorithm of treatment of these tumors. Most of the data are still emerging and further research is desirable. Close collaboration between the different specialists managing these pathologies is crucial.
KW - Aneurysmal bone cyst
KW - Bisphosphonate
KW - Bone marrow aspirate
KW - Denosumab
KW - Doxycycline
KW - Giant cell tumor
KW - Interferon
KW - Osteoid osteoma
KW - Selective arterial embolization
KW - Thermal ablation
UR - http://www.scopus.com/inward/record.url?scp=84980385976&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84980385976&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000001818
DO - 10.1097/BRS.0000000000001818
M3 - Review article
C2 - 27488295
AN - SCOPUS:84980385976
SN - 0362-2436
VL - 41
SP - S178-S185
JO - Spine
JF - Spine
ER -