Indication Surgery
1. Untractable Pain
2. Palliation pf Compression Symptoms, Acute Neurological Deficit
3. Spinal Instability
Surgery should be an option
4. SINS 7 above
5. Life Expectancy is more than 3-6 months
6. When post operative benefit outweigh the inherent risk
Consideration for open surgery
1. Large tumor burden The Big Three indication
2. Complex anatomy Surgery
3. Instability concern
Important factor consideration MIS or Open 1. Spinal Stability
4. Tumor Location 2. Neurologic (Symptoms
5. Neurological deficit and Type of Tumor)
6. Patient Preference and overall health 3. Prognosis
status
7. Similar Outcome
8. Expertise required
Durable local control
• Merujuk pada kemampuan pengobatan medis, biasanya
terapi radiasi, untuk menekan atau menghilangkan
tumor di lokasi aslinya dalam jangka waktu yang lama,
mencegah pertumbuhan kembali atau penyebarannya
di area yang dirawat. Konsep ini krusial dalam
penanganan kanker, karena mencapai kontrol lokal
yang berkelanjutan menghasilkan hasil kelangsungan
hidup dan kualitas hidup yang lebih baik, terutama bagi
pasien dengan penyakit metastasis yang hidup lebih
lama
• Preventing Relapse:
The goal is to stop the tumor from growing back in the treated region.
• Long-Term Outcome:
"Durable" implies that the control is not just a short-term effect but is sustained
over months or years.
• Treatment Impact:
Factors like stereotactic body radiation therapy (SBRT) and
hypofractionated radiation therapy (HFRT) are shown to provide high rates of
durable local control for various tumors.
• Clinical Significance:
High rates of durable local control are associated with improved survival and can be
a primary goal in treating both primary and metastatic cancers.
