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Stereotactic body radiation therapy (SBRT) for spinal metastases: 12 years of a single center experience

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Abstract

Objective

To assess the clinical outcomes of patients with spine metastases treated with SBRT at our institution.

Materials and methods

Patients with spine metastases treated with SBRT (1 fraction/18 Gy or 5 fractions/7 Gy) during the last 12 years have been analyzed. All patients were simulated supine in a vacuum cushion or with a shoulder mask. CT scans and MRI image registration were performed. Contouring was based on International Spine-Radiosurgery-Consortium-Consensus-Guidelines. Highly conformal-techniques (IMRT/VMAT) were used for treatment planning. Intra and interfraction (CBCT or X-Ray-ExacTrac) verification were mandatory.

Results

From February 2010 to January 2022, 129 patients with spinal metastases were treated with SBRT [1 fraction/18 Gy (75%) or 5 fractions/7 Gy] (25%). For patients with painful metastases (74/129:57%), 100% experienced an improvement in pain after SBRT. With a median follow-up of 14.2 months (average 22.9; range 0.5–140) 6 patients (4.6%) experienced local relapse. Local progression-free survival was different, considering metastases’s location (p < 0.04). The 1, 2 and 3 years overall survival (OS) were 91.2%, 85.1% and 83.2%, respectively. Overall survival was significantly better for patients with spine metastases of breast and prostate cancers compared to other tumors (p < 0.05) and significantly worse when visceral metastases were present (p < 0.05), when patients were metastatic de novo (p < 0.05), and in those patients receiving single fraction SBRT (p: 0.01).

Conclusions

According to our experience, SBRT for patients with spinal metastases was effective in terms of local control and useful to reach pain relief. Regarding the intent of the treatment, an adequate selection of patients is essential to propose this ablative approach.

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Data Availability

Data generated or analyzed during the study are available from the corresponding author (raquel.ciervide@gmail.com) by request.

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Funding

This research received no external funding. The authors did not receive support from any organization for the submitted work. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain

    Raquel Ciérvide, Ovidio Hernando, Mercedes López, Ángel Montero, Daniel Zucca, Emilio Sánchez, Beatriz Álvarez, Mariola García-Aranda, Xin Chen Zhao, Jeannette Valero, Rosa Alonso, Jaime Martí, Miguel Ángel de la Casa, Leire Alonso, Juan García, Paz Garcia de Acilu, Alejandro Prado, Pedro Fernandez Leton & Carmen Rubio

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  1. Raquel Ciérvide
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Corresponding author

Correspondence to Raquel Ciérvide.

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Institutional Review Board

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (CEIm) of FUNDACION DE INVESTIGACIÓN HM HOSPITALES (Código CEIm HM Hospitales: 23.02.2163-GHM) which certifies that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

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Informed consent was obtained from all subjects involved in the study.

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Ciérvide, R., Hernando, O., López, M. et al. Stereotactic body radiation therapy (SBRT) for spinal metastases: 12 years of a single center experience. Clin Transl Oncol 25, 3395–3404 (2023). https://doi.org/10.1007/s12094-023-03188-4

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