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Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution
OBJECT: This study aimed to clarify the outcomes of stereotactic body radiotherapy for spinal metastases with a uniform dose fractionation schedule in our institution. MATERIALS AND METHODS: Patients treated with spine stereotactic body radiotherapy were retrospectively reviewed. The prescribed dose...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202742/ https://www.ncbi.nlm.nih.gov/pubmed/30355246 http://dx.doi.org/10.1177/1533033818806472 |
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author | Ito, Kei Ogawa, Hiroaki Shimizuguchi, Takuya Nihei, Keiji Furuya, Tomohisa Tanaka, Hiroshi Karasawa, Katsuyuki |
author_facet | Ito, Kei Ogawa, Hiroaki Shimizuguchi, Takuya Nihei, Keiji Furuya, Tomohisa Tanaka, Hiroshi Karasawa, Katsuyuki |
author_sort | Ito, Kei |
collection | PubMed |
description | OBJECT: This study aimed to clarify the outcomes of stereotactic body radiotherapy for spinal metastases with a uniform dose fractionation schedule in our institution. MATERIALS AND METHODS: Patients treated with spine stereotactic body radiotherapy were retrospectively reviewed. The prescribed dose was 24 Gy in 2 fractions. End points were local control, pain control, and adverse events. Local control was defined as elimination, shrinkage, or stable disease in the tumor on imaging evaluations. Pain status was measured on a scale of 0 to 10 by patients’ self-reports, and pain response was defined as the time at which pain scale score decreased by 2 or more from the baseline score without increase in analgesics. In addition, various treatment- and tumor-specific factors were evaluated to determine predictive values for local and pain control. RESULTS: This study included 134 lesions in 131 patients, with: lesion histopathology, lung/colorectal/thyroid/renal/breast/prostate/sarcoma/other cancer, 24/22/18/14/12/10/6/25; reirradiation stereotactic body radiotherapy, 82 (61.2%) cases; and postoperative stereotactic body radiotherapy for epidural spinal cord compression, 45 (33.6%) cases. Median follow-up after stereotactic body radiotherapy was 9 months. The 1-year local control rate was 72.3%. Seventy (79.5%) of the 88 cases with pain from spinal metastases achieved pain response. The 1-year pain progression-free rate was 61.7%. Regarding metastases from colorectal cancer, local and pain control rates at 1 year were significantly lower compared with other cancer types (local control rate, 34.1% vs 81.8%; P < .01; pain progression-free rate, 36.9% vs 69.9%; P = .02). On multivariate analysis, colorectal cancer metastases and radiation history were identified as independent predictors of lower local and pain control rates. Radiation-induced myelopathy, radiculopathy, and vertebral compression fractures were observed in 0, 2 (1.5%), and 16 (11.9%) cases, respectively. CONCLUSIONS: This study showed that spine stereotactic body radiotherapy achieved good local and pain control, with a clinically acceptable safety profile. However, stereotactic body radiotherapy may be less effective against spinal metastases from colorectal cancer. |
format | Online Article Text |
id | pubmed-6202742 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-62027422018-10-30 Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution Ito, Kei Ogawa, Hiroaki Shimizuguchi, Takuya Nihei, Keiji Furuya, Tomohisa Tanaka, Hiroshi Karasawa, Katsuyuki Technol Cancer Res Treat Original Article OBJECT: This study aimed to clarify the outcomes of stereotactic body radiotherapy for spinal metastases with a uniform dose fractionation schedule in our institution. MATERIALS AND METHODS: Patients treated with spine stereotactic body radiotherapy were retrospectively reviewed. The prescribed dose was 24 Gy in 2 fractions. End points were local control, pain control, and adverse events. Local control was defined as elimination, shrinkage, or stable disease in the tumor on imaging evaluations. Pain status was measured on a scale of 0 to 10 by patients’ self-reports, and pain response was defined as the time at which pain scale score decreased by 2 or more from the baseline score without increase in analgesics. In addition, various treatment- and tumor-specific factors were evaluated to determine predictive values for local and pain control. RESULTS: This study included 134 lesions in 131 patients, with: lesion histopathology, lung/colorectal/thyroid/renal/breast/prostate/sarcoma/other cancer, 24/22/18/14/12/10/6/25; reirradiation stereotactic body radiotherapy, 82 (61.2%) cases; and postoperative stereotactic body radiotherapy for epidural spinal cord compression, 45 (33.6%) cases. Median follow-up after stereotactic body radiotherapy was 9 months. The 1-year local control rate was 72.3%. Seventy (79.5%) of the 88 cases with pain from spinal metastases achieved pain response. The 1-year pain progression-free rate was 61.7%. Regarding metastases from colorectal cancer, local and pain control rates at 1 year were significantly lower compared with other cancer types (local control rate, 34.1% vs 81.8%; P < .01; pain progression-free rate, 36.9% vs 69.9%; P = .02). On multivariate analysis, colorectal cancer metastases and radiation history were identified as independent predictors of lower local and pain control rates. Radiation-induced myelopathy, radiculopathy, and vertebral compression fractures were observed in 0, 2 (1.5%), and 16 (11.9%) cases, respectively. CONCLUSIONS: This study showed that spine stereotactic body radiotherapy achieved good local and pain control, with a clinically acceptable safety profile. However, stereotactic body radiotherapy may be less effective against spinal metastases from colorectal cancer. SAGE Publications 2018-10-24 /pmc/articles/PMC6202742/ /pubmed/30355246 http://dx.doi.org/10.1177/1533033818806472 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Article Ito, Kei Ogawa, Hiroaki Shimizuguchi, Takuya Nihei, Keiji Furuya, Tomohisa Tanaka, Hiroshi Karasawa, Katsuyuki Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title | Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title_full | Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title_fullStr | Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title_full_unstemmed | Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title_short | Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution |
title_sort | stereotactic body radiotherapy for spinal metastases: clinical experience in 134 cases from a single japanese institution |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202742/ https://www.ncbi.nlm.nih.gov/pubmed/30355246 http://dx.doi.org/10.1177/1533033818806472 |
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