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Vertebral Body Metastasis

  • Amol J. Ghia
  • Anussara Prayongrat
Chapter

Abstract

Spinal metastasis is a common manifestation among cancer patients, and almost one-third develop neurological deficit. Several treatment modalities including surgical intervention, radiation treatment, and medical treatment should be tailored for the individual patient depending on the clinical situation using appropriate prognostic factors and a multidisciplinary treatment decision approach. Owing to rapid improvement in image-guidance and radiation delivery techniques, stereotactic body radiotherapy (SBRT) has emerged as a treatment of choice in selected patients due to its physical and biological advantages as well as proven clinical benefits. Given the risks inherent in delivering ablative doses of radiation within close proximity of critical structures such as the spinal cord, appropriate multidisciplinary treatment decision and radiation delivery technique are necessary. Durable local control and palliative benefit with limited toxicity can be achieved with spinal SBRT in appropriately selected patients.

Keywords

Vertebral body metastasis Spinal metastasis Radiotherapy Radiosurgery Stereotactic radiotherapy 

Abbreviations

AAPM

The American Association of Physicists in Medicine

ASTRO

American Society for Radiation Oncology

BED

Biological equivalent dose

CBCT

Cone beam CT

cEBRT

Conventional external beam radiation treatment

CT

Computed tomography

CTV

Clinical target volume

EPID

Electronic portal imaging device

GTV

Gross target volume

IGRT

Image-guidance radiotherapy

KPS

Karnofsky performance status

KV

Kilovoltage

LINAC

Linear accelerator

LQ model

Linear-quadratic model

MESCC

Metastatic epidural spinal cord compression

MLC

Multileaf collimator

MRI

Magnetic resonance imaging

MV

Megavoltage

OARs

Organs at risk

OS

Overall survival

Pmax

Maximal point dose

PRISM

Prognostic index for spine metastasis

PRV

Planning organ-at-risk volume

PTV

Planning target volume

QUANTEC

Quantitative analysis of normal tissue effects in the clinic

RCC

Renal cell carcinoma

RM

Radiation myelopathy

RPA

Recursive partitioning analysis

RT

Radiotherapy

RTOG

Radiation Therapy Oncology Group

SBRT

Stereotactic body radiotherapy

SINS

Spine Instability Neoplastic Score

TPD

Time from primary diagnosis

VCF

Vertebral compression fracture

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyMD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Radiation OncologyKing Chulalongkorn Memorial HospitalBangkokThailand

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