Dr. Chao on Predicting Survival Following Stereotactic Spinal Radiosurgery

Samuel Chao, MD, Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, discusses spine stereotactic radiosurgery for the treatment of metastases located on the spine.

Certain factors can predict survival for patients that undergo spine stereotactic radiosurgery including age, performance status, and disease control. Treatment decisions can then be based on risk-status, says Chao. Patients can be grouped into risk categories, with patients in class 1, for example, surviving up to two years after spine stereotactic radiosurgery. Those in class 3, typically survive less than 6 months.

By grouping patients into risk categories, radiation oncologist can determine which patients will benefit the most from spine stereotactic radiosurgery, which is a relatively expensive procedure. Radiation oncologists may not necessarily want to apply this expensive therapy to a patient that may not do as well, says Chao. A patient that is expected to live two years is going to benefit the most from spine stereotactic radiosurgery. Spine metastases can be fairly morbid if it continues to progress.

For patients with shorter expected lifespans, alternative therapies that are less expensive might be more appropriate, says Chao.