Advertisement

Radiosurgery

  • Simon S. LoEmail author
  • Tithi Biswas
  • Rodney J. Ellis
  • Peter C. Gerszten
Chapter

Abstract

With the availability of advanced technology and radiation delivery techniques, it is now possible to deliver high doses of radiation precisely and accurately to a specific tumor volume with a very low risk of toxicity. Building upon the experience on intracranial stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), also called “extracranial surgery,” has emerged as an extremely effective nonsurgical local therapy option for cancer pain control. While there is a relatively large body of data on the use of SBRT for the palliation of pain from spinal metastases, the data on the use of SBRT for palliation of pain from non-spinal bone and visceral metastases are quite limited. More research and clinical trials are needed to better define the role of “extracranial radiosurgery” for cancer pain control.

Keywords

Stereotactic body radiotherapy Spinal metastasis Bone metastasis Visceral metastasis Cancer pain control 

References

  1. 1.
    Lo SS, Fakiris AJ, Chang EL, Mayr NA, Wang JZ, Papiez L, et al. Stereotactic body radiation therapy: a novel treatment modality. Nat Rev Clin Oncol. 2010;7(1):44–54.CrossRefGoogle Scholar
  2. 2.
    Timmerman RD, Kavanagh BD, Cho LC, Papiez L, Xing L. Stereotactic body radiation therapy in multiple organ sites. J Clin Oncol. 2007;25(8):947–52.CrossRefGoogle Scholar
  3. 3.
    Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010;303(11):1070–6.CrossRefGoogle Scholar
  4. 4.
    Jhaveri PM, Teh BS, Paulino AC, Blanco AI, Lo SS, Butler EB, et al. A dose-response relationship for time to bone pain resolution after stereotactic body radiotherapy (SBRT) for renal cell carcinoma (RCC) bony metastases. Acta Oncol. 2012;51(5):584–8.CrossRefGoogle Scholar
  5. 5.
    Lo SS, Sahgal A, Wang JZ, Mayr NA, Sloan A, Mendel E, et al. Stereotactic body radiation therapy for spinal metastases. Discov Med. 2010;9(47):289–96.PubMedGoogle Scholar
  6. 6.
    Lo SS, Chang EL, Yamada Y, Sloan AE, Suh JH, Mendel E. Stereotactic radiosurgery and radiation therapy for spinal tumors. Expert Rev Neurother. 2007;7(1):85–93.CrossRefGoogle Scholar
  7. 7.
    Sahgal A, Larson DA, Chang EL. Stereotactic body radiosurgery for spinal metastases: a critical review. Int J Radiat Oncol Biol Phys. 2008;71(3):652–65.CrossRefGoogle Scholar
  8. 8.
    Li W, Sahgal A, Foote M, Millar BA, Jaffray DA, Letourneau D. Impact of immobilization on intrafraction motion for spine stereotactic body radiotherapy using cone beam computed tomography. Int J Radiat Oncol Biol Phys. 2012;84(2):520–6.CrossRefGoogle Scholar
  9. 9.
    Lutz S, Berk L, Chang E, Chow E, Hahn C, Hoskin P, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys. 2011;79(4):965–76.CrossRefGoogle Scholar
  10. 10.
    Lutz ST, Lo SS, Chang EL, Galanopoulos N, Howell DD, Kim EY, et al. ACR Appropriateness Criteria(R) non-spine bone metastases. J Palliat Med. 2012;15(5):521–6.CrossRefGoogle Scholar
  11. 11.
    Amdur RJ, Bennett J, Olivier K, Wallace A, Morris CG, Liu C, et al. A prospective, phase II study demonstrating the potential value and limitation of radiosurgery for spine metastases. Am J Clin Oncol. 2009;32:515.CrossRefGoogle Scholar
  12. 12.
    Choi CY, Adler JR, Gibbs IC, Chang SD, Jackson PS, Minn AY, et al. Stereotactic radiosurgery for treatment of spinal metastases recurring in close proximity to previously irradiated spinal cord. Int J Radiat Oncol Biol Phys. 2010;78(2):499–506.CrossRefGoogle Scholar
  13. 13.
    Damast S, Wright J, Bilsky M, Hsu M, Zhang Z, Lovelock M, et al. Impact of dose on local failure rates after image-guided reirradiation of recurrent paraspinal metastases. Int J Radiat Oncol Biol Phys. 2011;81(3):819–26.CrossRefGoogle Scholar
  14. 14.
    Garg AK, Shiu AS, Yang J, Wang XS, Allen P, Brown BW, et al. Phase 1/2 trial of single-session stereotactic body radiotherapy for previously unirradiated spinal metastases. Cancer. 2012;118:5069–77.CrossRefGoogle Scholar
  15. 15.
    Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine (Phila Pa 1976). 2007;32(2):193–9.CrossRefGoogle Scholar
  16. 16.
    Gibbs IC, Kamnerdsupaphon P, Ryu MR, Dodd R, Kiernan M, Chang SD, et al. Image-guided robotic radiosurgery for spinal metastases. Radiother Oncol. 2007;82(2):185–90.CrossRefGoogle Scholar
  17. 17.
    Sheehan JP, Shaffrey CI, Schlesinger D, Williams BJ, Arlet V, Larner J. Radiosurgery in the treatment of spinal metastases: tumor control, survival, and quality of life after helical tomotherapy. Neurosurgery. 2009;65(6):1052–61. discussion 61–2.CrossRefGoogle Scholar
  18. 18.
    Wang XS, Rhines LD, Shiu AS, Yang JN, Selek U, Gning I, et al. Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1–2 trial. Lancet Oncol. 2012;13(4):395–402.CrossRefGoogle Scholar
  19. 19.
    Sahgal A, Ames C, Chou D, Ma L, Huang K, Xu W, et al. Stereotactic body radiotherapy is effective salvage therapy for patients with prior radiation of spinal metastases. Int J Radiat Oncol Biol Phys. 2009;74(3):723–31.CrossRefGoogle Scholar
  20. 20.
    Yamada Y, Bilsky MH, Lovelock DM, Venkatraman ES, Toner S, Johnson J, et al. High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions. Int J Radiat Oncol Biol Phys. 2008;71(2):484–90.CrossRefGoogle Scholar
  21. 21.
    Masucci GL, Yu E, Ma L, Chang EL, Letourneau D, Lo S, et al. Stereotactic body radiotherapy is an effective treatment in reirradiating spinal metastases: current status and practical considerations for safe practice. Expert Rev Anticancer Ther. 2011;11(12):1923–33.CrossRefGoogle Scholar
  22. 22.
    Sahgal A, Ma L, Weinberg V, Gibbs IC, Chao S, Chang UK, et al. Reirradiation human spinal cord tolerance for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys. 2012;82(1):107–16.CrossRefGoogle Scholar
  23. 23.
    Huang Z, Mayr NA, Yuh WT, Wang JZ, Lo SS. Reirradiation with stereotactic body radiotherapy: analysis of human spinal cord tolerance using the generalized linear-quadratic model. Future Oncol. 2013;9(6):879–87.CrossRefGoogle Scholar
  24. 24.
    Mahadevan A, Floyd S, Wong E, Jeyapalan S, Groff M, Kasper E. Stereotactic body radiotherapy reirradiation for recurrent epidural spinal metastases. Int J Radiat Oncol Biol Phys. 2011;81(5):1500–5.CrossRefGoogle Scholar
  25. 25.
    Heron DE, Rajagopalan MS, Stone B, Burton S, Gerszten PC, Dong X, et al. Single-session and multisession CyberKnife radiosurgery for spine metastases-University of Pittsburgh and Georgetown University experience. J Neurosurg Spine. 2012;17(1):11–8.CrossRefGoogle Scholar
  26. 26.
    Gerszten PC, Monaco EA 3rd. Complete percutaneous treatment of vertebral body tumors causing spinal canal compromise using a transpedicular cavitation, cement augmentation, and radiosurgical technique. Neurosurg Focus. 2009;27(6):E9.CrossRefGoogle Scholar
  27. 27.
    Chawla S, Chen Y, Katz AW, Muhs AG, Philip A, Okunieff P, et al. Stereotactic body radiotherapy for treatment of adrenal metastases. Int J Radiat Oncol Biol Phys. 2009;75(1):71–5.CrossRefGoogle Scholar
  28. 28.
    Guiou M, Mayr NA, Kim EY, Williams T, Lo SS. Stereotactic body radiotherapy for adrenal metastases from lung cancer. J Radiat Oncol. 2012;1:155–63.CrossRefGoogle Scholar
  29. 29.
    Sahgal A, Weinberg V, Ma L, Chang E, Chao S, Muacevic A, et al. Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice. Int J Radiat Oncol Biol Phys. 2013;85(2):341–7.CrossRefGoogle Scholar
  30. 30.
    Garg AK, Wang XS, Shiu AS, Allen P, Yang J, McAleer MF, et al. Prospective evaluation of spinal reirradiation by using stereotactic body radiation therapy: The University of Texas MD Anderson Cancer Center experience. Cancer. 2011;117(15):3509–16.CrossRefGoogle Scholar
  31. 31.
    Sahgal A, Atenafu EG, Chao S, Al-Omair A, Boehling N, Balagamwala EH, 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(27):3426–31.CrossRefGoogle Scholar
  32. 32.
    Chiang A, Zeng L, Zhang L, Lochray F, Korol R, Loblaw A, et al. Pain flare is a common adverse event in steroid-naive patients after spine stereotactic body radiation therapy: a prospective clinical trial. Int J Radiat Oncol Biol Phys. 2013;86:638–42.CrossRefGoogle Scholar
  33. 33.
    Balagamwala EH, Angelov L, Koyfman SA, Suh JH, Reddy CA, Djemil T, et al. Single-fraction stereotactic body radiotherapy for spinal metastases from renal cell carcinoma. J Neurosurg Spine. 2012;17(6):556–64.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Simon S. Lo
    • 1
    Email author
  • Tithi Biswas
    • 2
  • Rodney J. Ellis
    • 2
  • Peter C. Gerszten
    • 2
  1. 1.University of Washington School of Medicine, Department of Radiation OncologySeattleUSA
  2. 2.University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Department of Radiation OncologyClevelandUSA

Personalised recommendations