@article{APM19067,
author = {Ruchika Gutt and Sheetal Malhotra and Shruti Jolly and Drew Moghanaki and Alice V. Cheuk and Helen Fosmire and Maria Kelly and Lori Hoffman-Hogg and Stephen Lutz and Mitchell Anscher and George Dawson and On behalf of the Veterans Health Administration Palliative Radiotherapy Task Force},
title = {Management of metastatic spinal cord compression among Veterans Health Administration radiation oncologists},
journal = {Annals of Palliative Medicine},
volume = {7},
number = {2},
year = {2018},
keywords = {},
abstract = {Background: Optimal management of metastatic spinal cord compression (MSCC) improves functional outcomes in patients with metastatic disease. This survey study evaluated management of MSCC by Veterans Health Administration (VHA) radiation oncologists (ROs), to determine whether management of MSCC correlates with American College of Radiology (ACR) guidelines, and to compare times to initiation of treatment between surgery and radiotherapy (RT).
Methods: Surveys emailed to 79 VHA ROs included questions on steroid use, surgical care, palliative care, fractionation of irradiation, re-irradiation, and management of common MSCC case scenarios. Follow-up phone calls were made to encourage survey participation. Descriptive statistics and chi-square testing were done to show significant associations.
Results: The survey yielded an 81.0% response rate; 79.4% of ROs had read the ACR Appropriateness Criteria® Spinal Bone Metastases. The majority (87.3%) prefer 30 Gy/10 fractions for MSCC, and all respondents recommend steroid therapy in conjunction with RT. When used, RT was more often initiated within 24 hours than was neurosurgery (83.9% vs. 34.5%, P75%) management concurred with ACR guidelines.
Conclusions: The majority of VHA ROs are familiar with the ACR Appropriateness Criteria® Spinal Bone Metastases and practice accordingly. Treatment within 24 hours is more likely when RT is the primary modality compared to when surgical decompression precedes RT.},
issn = {2224-5839}, url = {https://apm.amegroups.org/article/view/19067}
}