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Open Access Gold as soon as Publ. Version/Full Text is submitted to ZB.
SBRT of spinal metastases using a simultaneous integrated boost concept in oligometastatic cancer patients is safe and effective.
Cancers 15:5813 (2023)
(1) Purpose: To assess the safety and effectivity of stereotactic body radiotherapy (SBRT) on spinal metastases utilizing a simultaneous integrated boost (SIB) concept in oligometastatic cancer patients. (2) Methods: 62 consecutive patients with 71 spinal metastases received SIB-SBRT between 01/2013 and 09/2022 at our institution. We retrospectively analyzed toxicity, local tumor control (LC), and progression-free (PFS) and overall survival (OS) following SIB-SBRT and assessed possible influencing factors (Kaplan-Meier estimator, log-rank test and Cox proportional-hazards model). (3) Results: SIB-SBRT was delivered in five fractions, mostly with 25/40 Gy (n = 43; 60.56%) and 25/35 Gy (n = 19, 26.76%). Estimated rates of freedom from VCF were 96.1/90.4% at one/two years. VCF development was significantly associated with osteoporosis (p < 0.001). No ≥ grade III acute and one grade III late toxicity (VCF) were observed. Estimated LC rates at one/two years were 98.6/96.4%, and histology was significantly associated with local treatment failure (p = 0.039). Median PFS/OS was 10 months (95% CI 6.01-13.99)/not reached. Development of metastases ≥ one year after initial diagnosis and Karnofsky Performance Score ≥ 90% were predictors for superior PFS (p = 0.038) and OS (p = 0.012), respectively. (4) Conclusion: Spinal SIB-SBRT yields low toxicity and excellent LC. It may be utilized in selected oligometastatic patients to improve prognosis. To the best of our knowledge, we provide the first clinical data on the toxicity and effectivity of SIB-SBRT in spinal metastases in a larger patient cohort.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Sbrt ; Sib ; Vcf ; Dose Escalation ; Oligometastatic ; Spinal Metastases ; Stereotactic Body Radiotherapy; Stereotactic Body Radiotherapy; Vertebral Compression Fracture; Radiation-therapy; Bone Metastases; Phase 2/3; Radiosurgery; Multicenter; Pain
ISSN (print) / ISBN
2072-6694
Journal
Cancers
Quellenangaben
Volume: 15,
Issue: 24,
Article Number: 5813
Publisher
MDPI
Publishing Place
St Alban-anlage 66, Ch-4052 Basel, Switzerland
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)
Grants
German Cancer Consortium (DKTK)