Benign Tumours of the Spine: Has new Chemotherapy and Interventional Radiology Changed the Treatment Paradigm?

Raphaële Charest-Morin, Stefano Boriani, Charles G. Fisher, Shreyaskumar R. Patel, Norio Kawahara, Ehud Mendel, Chetan Bettegowda, Laurence D. Rhines

Research output: Contribution to journalArticlepeer-review

Abstract

STUDY DESIGN.: Clinically based systematic review. OBJECTIVE.: To determine the role of 1) medical treatment and 2) 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 4 multicenter prospective studies. Nine studies were found on bisphosphonates and 6 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 4, 2 and 3 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.Level of Evidence: 4

Original languageEnglish
Pages (from-to)S178-S185
Number of pages8
JournalSpine
DOIs
Publication statusAccepted/In press - Aug 3 2016

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

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