Research Article
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Year 2022, Volume: 5 Issue: 5, 1215 - 1219, 25.09.2022
https://doi.org/10.32322/jhsm.1134145

Abstract

References

  • De Felice F, Piccioli A, Musio D, Tombolini V. The role of radiation therapy in bone metastases management. Oncotarget 2017; 8: 25691-9.
  • Lutz S, Balboni T, Jones J, et al. Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline. Pract Radiat Oncol 2017; 7: 4-12.
  • Hartsell WF, Scott CB, Bruner DW, et al. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst 2005; 97: 798-804.
  • Martin A, Gaya A. Stereotactic body radiotherapy: a review. Clin Oncol (R Coll Radiol) 2010; 22: 157-72.
  • Rijken J, Crowe S, Trapp J, Kairn T. A review of stereotactic body radiotherapy for the spine. Phys Eng Sci Med 2020; 43: 799-824.
  • Ryu S, Deshmukh S, Timmerman RD, et al. Radiosurgery compared to external beam radiotherapy for localized spine metastasis: phase III results of NRG oncology/RTOG 0631. Int J Radiat Oncol Biol Phys 2019; 105: S2-S3.
  • Sahgal A, Myrehaug SD, Siva S, et al. Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2/3 trial. Lancet Oncol 2021; 22: 1023-33.
  • Fisher CG, DiPaola CP, Ryken TC, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine (Phila Pa 1976) 2010; 35: E1221-9.
  • Hanna GG, Murray L, Patel R, et al. UK Consensus on Normal Tissue Dose Constraints for Stereotactic Radiotherapy. Clin Oncol (R Coll Radiol) 2018; 30: 5-14.
  • Sahgal A, Weinberg V, Ma L, et al. Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice. Int J Radiat Oncol Biol Phys 2013; 85: 341-7.
  • Common Terminology Criteria for Adverse Events (CTCAE) v.4.03 [09.06.2022]. Available from: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf.
  • Sprave T, Verma V, Forster R, et al. Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiother Oncol 2018; 128: 274-82.
  • Alongi F, Arcangeli S, Filippi AR, Ricardi U, Scorsetti M. Review and uses of stereotactic body radiation therapy for oligometastases. Oncologist 2012; 17: 1100-7.
  • Tree AC, Khoo VS, Eeles RA, et al. Stereotactic body radiotherapy for oligometastases. Lancet Oncol 2013; 14: e28-37.
  • Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the SABR-COMET phase II randomized trial. J Clin Oncol 2020; 38: 2830-8.
  • Stereotactic Ablative Radiotherapy for Comprehensive Treatment of Oligometastatic (1-3 Metastases) Cancer (SABR-COMET-3) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/NCT03862911.
  • Stereotactic Ablative Radiotherapy for Comprehensive Treatment of 4-10 Oligometastatic Tumors (SABR-COMET 10) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/NCT03721341.
  • Conventional care versus radioablation (stereotactic body radiotherapy) for extracranial oligometastases (CORE) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/ NCT02759783.
  • Sahgal A, Atenafu EG, Chao S, et al. Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score. J Clin Oncol 2013; 31: 3426-31.
  • Mehta N, Zavitsanos PJ, Moldovan K, et al. Local failure and vertebral body fracture risk using multifraction stereotactic body radiation therapy for spine metastases. Adv Radiat Oncol 2018; 3: 245-51.
  • Jawad MS, Fahim DK, Gerszten PC, et al. Vertebral compression fractures after stereotactic body radiation therapy: a large, multi-institutional, multinational evaluation. J Neurosurg Spine 2016; 24: 928-36.
  • Osborn VW, Lee A, Yamada Y. Stereotactic body radiation therapy for spinal malignancies. Technol Cancer Res Treat 2018; 17: 1533033818802304.

Evaluation of treatment results of stereotactic body radiotherapy for spinal metastases: A single center experience

Year 2022, Volume: 5 Issue: 5, 1215 - 1219, 25.09.2022
https://doi.org/10.32322/jhsm.1134145

Abstract

Aim: To assess oncological outcomes and adverse events of patients receiving single or multi-fraction stereotactic body radiotherapy (SBRT) for spine metastases.
Material and Method: Patients with any pathologically proven solid tumor histology who had SBRT to the spine for recurrent or metastatic disease between the years 2010 and 2021 at our department were identified from institutional database. Patient, tumor and treatment characteristics, and follow-up medical records were retrospectively reviewed. Local control (LC) and overall survival (OS) rates were calculated, and adverse events were evaluated.
Results: A total of 47 patients were treated to 50 spine metastases. Median age was 53 years for all patients. Histologies included breast cancer (45%), non-small cell lung cancer (NSCLC; 21%), prostate cancer (15%) and other types (19%). Median follow-up was 16 months for all patients. Of 47 patients, six (13%) developed local failure and 15 (32%) died without local failure. One and two-year actuarial LC rates were 90.1% and 83.6%, respectively. One and two-year OS rates were 75.1% and 62.7%, respectively. Twenty-two (47%) patients had pain before SBRT. Fifteen (68%) of them had complete or partial pain response at 3 months after SBRT. Vertebral compression fracture, which was grade 1 in severity according to the Common Terminology Criteria for Adverse Events (CTCAE [v.4.03]), was observed in only one (2%) patient and it occurred 46 months after SBRT. No cases of treatment-related radiation myelopathy or any≥grade 3 RT induced acute or late toxicities occurred.
Conclusion: This study supports that SBRT to the spine results in high LC without any significant toxicity. The results of ongoing phase 3 trials will highlight whether this high LC benefit reflects to survival in oligometastatic disease.

References

  • De Felice F, Piccioli A, Musio D, Tombolini V. The role of radiation therapy in bone metastases management. Oncotarget 2017; 8: 25691-9.
  • Lutz S, Balboni T, Jones J, et al. Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline. Pract Radiat Oncol 2017; 7: 4-12.
  • Hartsell WF, Scott CB, Bruner DW, et al. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst 2005; 97: 798-804.
  • Martin A, Gaya A. Stereotactic body radiotherapy: a review. Clin Oncol (R Coll Radiol) 2010; 22: 157-72.
  • Rijken J, Crowe S, Trapp J, Kairn T. A review of stereotactic body radiotherapy for the spine. Phys Eng Sci Med 2020; 43: 799-824.
  • Ryu S, Deshmukh S, Timmerman RD, et al. Radiosurgery compared to external beam radiotherapy for localized spine metastasis: phase III results of NRG oncology/RTOG 0631. Int J Radiat Oncol Biol Phys 2019; 105: S2-S3.
  • Sahgal A, Myrehaug SD, Siva S, et al. Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2/3 trial. Lancet Oncol 2021; 22: 1023-33.
  • Fisher CG, DiPaola CP, Ryken TC, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine (Phila Pa 1976) 2010; 35: E1221-9.
  • Hanna GG, Murray L, Patel R, et al. UK Consensus on Normal Tissue Dose Constraints for Stereotactic Radiotherapy. Clin Oncol (R Coll Radiol) 2018; 30: 5-14.
  • Sahgal A, Weinberg V, Ma L, et al. Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice. Int J Radiat Oncol Biol Phys 2013; 85: 341-7.
  • Common Terminology Criteria for Adverse Events (CTCAE) v.4.03 [09.06.2022]. Available from: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf.
  • Sprave T, Verma V, Forster R, et al. Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiother Oncol 2018; 128: 274-82.
  • Alongi F, Arcangeli S, Filippi AR, Ricardi U, Scorsetti M. Review and uses of stereotactic body radiation therapy for oligometastases. Oncologist 2012; 17: 1100-7.
  • Tree AC, Khoo VS, Eeles RA, et al. Stereotactic body radiotherapy for oligometastases. Lancet Oncol 2013; 14: e28-37.
  • Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the SABR-COMET phase II randomized trial. J Clin Oncol 2020; 38: 2830-8.
  • Stereotactic Ablative Radiotherapy for Comprehensive Treatment of Oligometastatic (1-3 Metastases) Cancer (SABR-COMET-3) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/NCT03862911.
  • Stereotactic Ablative Radiotherapy for Comprehensive Treatment of 4-10 Oligometastatic Tumors (SABR-COMET 10) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/NCT03721341.
  • Conventional care versus radioablation (stereotactic body radiotherapy) for extracranial oligometastases (CORE) [20.06.2022]. Available from: https://clinicaltrials.gov/ct2/show/ NCT02759783.
  • Sahgal A, Atenafu EG, Chao S, et al. Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score. J Clin Oncol 2013; 31: 3426-31.
  • Mehta N, Zavitsanos PJ, Moldovan K, et al. Local failure and vertebral body fracture risk using multifraction stereotactic body radiation therapy for spine metastases. Adv Radiat Oncol 2018; 3: 245-51.
  • Jawad MS, Fahim DK, Gerszten PC, et al. Vertebral compression fractures after stereotactic body radiation therapy: a large, multi-institutional, multinational evaluation. J Neurosurg Spine 2016; 24: 928-36.
  • Osborn VW, Lee A, Yamada Y. Stereotactic body radiation therapy for spinal malignancies. Technol Cancer Res Treat 2018; 17: 1533033818802304.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Uğur Yılmaz 0000-0001-9430-0239

Gökhan Yaprak 0000-0001-8521-8073

Naciye Işık 0000-0002-7444-5913

Publication Date September 25, 2022
Published in Issue Year 2022 Volume: 5 Issue: 5

Cite

AMA Yılmaz U, Yaprak G, Işık N. Evaluation of treatment results of stereotactic body radiotherapy for spinal metastases: A single center experience. J Health Sci Med / JHSM. September 2022;5(5):1215-1219. doi:10.32322/jhsm.1134145

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