Case 2
BlackArmor® Carbon/PEEK Implants Enable the Use of High-Precision Proton Therapy
60-year-old female patient with suspected spinal metastasis at Th11. The patient’s MRI showed a spinal cord compression caused by a lesion.
Therapy
Surgical treatment through laminectomy, debulking, biopsy, and dorsal stabilization with titanium implants.
Histological finding: Chordoma. The resulting decision for adjuvant proton therapy called for the revision of contraindicated titanium implants and the use of BlackArmor® Carbon/PEEK implants.
Replacement of titanium implants with BlackArmor® Carbon/PEEK implants, dorsal percutaneous stabilization with the VADER® Pedicle System and anterior stabilization with the KONG®-TL VBR System
Precise planning and safe performance of the indicated proton therapy could be carried out.
17 months postoperatively no radiological evidence of a tumor
BlackArmor® Carbon/PEEK expands radiation therapy options.1Shi C. et al. (2022): Comprehensive Evaluation of Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) Spinal Hardware for Proton and Photon Planning. Technology in Cancer Research & Treatment. (PubMed, PMID: 35410544)5Schmidhalter D. et al. (2020): Dosimetric Analysis of Spine SBRT in Case of CFR-PEEK Implants. Annual SASRO Meeting.7Poel R. et al. (2020): Assessing the Advantages of CFR-PEEK over Titanium Spinal Stabilization Implants in Proton Therapy – A Phantom Study. Physics in Medicine and Biology. (PubMed, PMID: 32315991)8Henzen D. et al. (2022): Feasibility of Postoperative Spine Stereotactic Body Radiation Therapy in Proximity of Carbon and Titanium Hybrid Implants Using a Robotic Radiotherapy Device. Radiation Oncology. (PubMed, PMID: 35549961)Since the tumor entity is not always determined preoperatively, the primary choice of implants is essential. Cutting-edge technologies such as stereotactic body radiotherapy (SBRT) and proton therapy are highly effective and often indicated if conventional radiation therapy reaches its limits. Artifact-free imaging is of even greater importance because the adjacent organs at risk must be very precisely delineated during planning. BlackArmor® Carbon/PEEK can optimize the critical planning and validation processes as well as the delivery of the prescribed dose.1Shi C. et al. (2022): Comprehensive Evaluation of Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) Spinal Hardware for Proton and Photon Planning. Technology in Cancer Research & Treatment. (PubMed, PMID: 35410544)2Krätzig T. et al. (2021): Carbon-Fiber-Reinforced PEEK versus Titanium Implants: An In Vitro Comparison of Susceptibility Artifacts in CT and MR Imaging. Neurosurgical Review. (PubMed, PMID: 32930911)3Müller BS. et al. (2020): The Dosimetric Impact of Stabilizing Spinal Implants in Radiotherapy Treatment Planning with Protons and Photons: Standard Titanium Alloy vs. Radiolucent Carbon-Riber-Reinforced PEEK Systems. Journal of Applied Clinical Medical Physics. (PubMed, PMID: 32476247)4Klippel N. (2018): Dosimetric Impact of Titanium and Carbon Implants in Photon Therapy. Annual SSRMP Meeting.5Schmidhalter D. et al. (2020): Dosimetric Analysis of Spine SBRT in Case of CFR-PEEK Implants. Annual SASRO Meeting.6Ringel F. et al. (2017): Radiolucent Carbon Fiber-Reinforced Pedicle Screws for Treatment of Spinal Tumors: Advantages for Radiation Planning and Follow-Up Imaging. World Neurosurgery. (PubMed, PMID: 28478252)7Poel R. et al. (2020): Assessing the Advantages of CFR-PEEK over Titanium Spinal Stabilization Implants in Proton Therapy – A Phantom Study. Physics in Medicine and Biology. (PubMed, PMID: 32315991)