Spine metastases: Current treatments and future directions

Ran Harel, Lilyana Angelov*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

154 Scopus citations


Spinal metastases are the most frequently encountered spinal tumour and can affect up to 50% of cancer patients. Both the incidence and prevalence of metastases are thought to be rising due to better detection and treatment options of the systemic malignancy resulting in increased patient survival. Further, the development and access to newer imaging modalities have resulted in easier screening and diagnosis of spine metastases. Current evidence suggests that pain, neurological symptoms and quality of life are all improved if patients with spine metastases are treated early and aggressively. However, selection of the appropriate therapy depends on several factors including primary histology, extent of the systemic disease, existing co-morbidities, prior treatment modalities, patient age and performance status, predicted life expectancy and available resources. This article reviews the currently available therapeutic options for spinal metastases including conventional external beam radiation therapy, open surgical decompression and stabilisation, vertebral augmentation and other minimally invasive surgery (MIS) options, stereotactic spine radiosurgery, bisphosphonates, systemic radioisotopes and chemotherapy. An algorithm for the management of spine metastases is also proposed. It outlines a multidisciplinary and integrated approach to these patients and it is hoped that this along with future advances and research will result in improved patient care and outcomes.

Original languageEnglish
Pages (from-to)2696-2707
Number of pages12
JournalEuropean Journal of Cancer
Issue number15
StatePublished - Oct 2010
Externally publishedYes


  • Radiation therapy
  • Spine metastases
  • Spine radiosurgery
  • Spine surgery


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