Introduction: While surgery remains a critical part of the treatment for most primary bone tumors, it is only a component of a comprehensive management plan, and often a multidisciplinary approach consisting of medical oncology, and interventional radiology is mandatory to optimize these patient outcomes. Our aim with this study is to investigate the therapeutic response among primary bone spine tumors treated with SRS.
Methods: We performed a systematic literature search in the databases Medline, Embase (Ovid), Scopus, Web of Science Advance, and Cochrane Central from inception to July 8, 2024. We included studies that reported on outcomes of SRS in patients with primary spine bone tumors and meta-analyzed the proportions of recurrence, progression, and extent to which local control (LC) was achieved. The quality of included studies was assessed using the ROBINS-I tool for non-randomized studies.
Results: We identified 5 studies where LC data was given for a total of 87 primary spinal bone tumors, and our compiled analysis found that a pooled proportion of LC among them was 0.81[95% CI: 0.56; 0.94]. The subgroup analysis of the pooled proportion of LC among Chordomas (n=69) was found to be 0.82 [95% CI: 0.59; 0.93]. For recurrence, we identified four studies that reported data for a total of 57 tumors treated with SRS, and a pooled proportion of recurrence among bony spinal tumors treated with SRS is 0.14 [95% CI: 0.04; 0.41]. We were only able to conduct subgroup analyses of recurrence among 4 studies with a total of 39 cases of chordomas, and the pooled proportion of recurrence after SRS, among chordomas is 0.14 [95% CI: 0.03: 0.47].
Conclusion : Based on our study, the use of SRS for treating primary spinal bone tumors achieves promising results in terms of local control (82%), while 14% of the cases had recurrence, and 40% showed tumor progression. Thus, SRS as a primary treatment modality for bone spine tumors, still needs further modifications so as to have enhanced results and improved patient outcomes.