Open AccessThe importance of multidisciplinary care for spine metastases: initial tumor management
Author(s) -
William Newman,
Ankur Patel,
Jacob L. Goldberg,
Mark H. Bilsky
Publication year - 2020
Publication title -
neuro-oncology practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 14
eISSN - 2054-2585
pISSN - 2054-2577
DOI - 10.1093/nop/npaa056
Subject(s) - medicine , multidisciplinary approach , systemic therapy , intensive care medicine , psychological intervention , radiation therapy , cancer , medical physics , radiology , social science , psychiatry , sociology , breast cancer
Spine metastases are very common in cancer patients often requiring urgent assessment and the initiation of therapy. Treatment paradigms have changed exponentially over the past decade with the evolution and integration of stereotactic body radiotherapy, minimally invasive spine techniques, and systemic options including biologics and checkpoint inhibitors. These advances necessitate multidisciplinary assessments and interventions to optimize outcomes. The NOMS framework provides a mechanism for all practitioners to evaluate the 4 sentinel assessments required to make decisions in patients with spine metastases: Neurologic, Oncologic, Mechanical Stability, and Systemic disease. The NOMS framework is continuously updated with the integration of newer technologies and evidence-based medicine as they become available. This paper presents the current iteration of NOMS with a focus on the role of medical and neuro-oncologists in the assessment and treatment of metastatic spine tumors.