TY - JOUR
T1 - Clinical Evaluation of the Spinal Instability Neoplastic Score in Patients Treated with Radiotherapy for Symptomatic Spinal Bone Metastases
AU - Bollen, Laurens
AU - Groenen, Karlijn
AU - Pondaag, Willem
AU - Van Rijswijk, Carla S.P.
AU - Fiocco, Marta
AU - Van Der Linden, Yvette M.
AU - Dijkstra, Sander P.D.
N1 - Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/8/15
Y1 - 2017/8/15
N2 - 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.
AB - 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.
KW - spinal bone metastases
KW - Spinal Instability Neoplastic Score
KW - stability
UR - http://www.scopus.com/inward/record.url?scp=85026286621&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000002058
DO - 10.1097/BRS.0000000000002058
M3 - Article
C2 - 28800570
AN - SCOPUS:85026286621
SN - 0362-2436
VL - 42
SP - E956-E962
JO - Spine
JF - Spine
IS - 16
ER -