Stereotactic body radiotherapy for de novo spinal metastases: systematic review.

Details

Serval ID
serval:BIB_BFE70EA53F3C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Stereotactic body radiotherapy for de novo spinal metastases: systematic review.
Journal
Journal of neurosurgery. Spine
Author(s)
Husain Z.A., Sahgal A., De Salles A., Funaro M., Glover J., Hayashi M., Hiraoka M., Levivier M., Ma L., Martínez-Alvarez R., Paddick J.I., Régis J., Slotman B.J., Ryu S.
ISSN
1547-5646 (Electronic)
ISSN-L
1547-5646
Publication state
Published
Issued date
09/2017
Peer-reviewed
Oui
Volume
27
Number
3
Pages
295-302
Language
english
Notes
Publication types: Journal Article ; Practice Guideline ; Review
Publication Status: ppublish
Abstract
OBJECTIVE The aim of this systematic review was to provide an objective summary of the published literature pertaining to the use of stereotactic body radiation therapy (SBRT) specific to previously untreated spinal metastases. METHODS The authors performed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of the literature found in a search of Medline, PubMed, Embase, and the Cochrane Library up to March 2015. The search strategy was limited to publications in the English language. RESULTS A total of 14 full-text articles were included in the analysis. All studies were retrospective except for 2 studies, which were prospective. A total of 1024 treated spinal lesions were analyzed. The median follow-up time ranged from 9 to 49 months. A range of dose-fractionation schemes was used, the most common of which were 16-24 Gy/1 fraction (fx), 24 Gy/2 fx, 24-27 Gy/3 fx, and 30-35 Gy/5 fx. In studies that reported crude results regarding in-field local tumor control, 346 (85%) of 407 lesions remained controlled. For studies that reported actuarial values, the weighted average revealed a 90% 1-year local control rate. Only 3 studies reported data on complete pain response, and the weighted average of these results yielded a complete pain response rate of 54%. The most common toxicity was new or progressing vertebral compression fracture, which was observed in 9.4% of cases; 2 cases (0.2%) of neurologic injury were reported. CONCLUSION There is a paucity of prospective data specific to SBRT in patients with spinal metastases not otherwise irradiated. This systematic review found that SBRT is associated with favorable rates of local control (approximately 90% at 1 year) and complete pain response (approximately 50%), and low rates of serious adverse events were found. Practice guidelines are summarized based on these data and International Stereotactic Radiosurgery Society consensus.

Keywords
Humans, Radiosurgery/adverse effects, Spinal Neoplasms/radiotherapy, Spinal Neoplasms/secondary, BED = biologically equivalent dose, CTV = clinical target volume, EBRT = external-beam radiation therapy, GTV = gross tumor volume, ISRS = International Stereotactic Radiosurgery Society, MDACC = MD Anderson Cancer Center, RCC = renal cell carcinoma, SBRT, SBRT = stereotactic body radiation therapy, fx = fraction(s), oncology, spinal metastases, stereotactic radiosurgery, systematic review
Pubmed
Web of science
Open Access
Yes
Create date
22/06/2017 18:52
Last modification date
20/08/2019 15:34
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