Clinical Outcome of Dose-Escalated Image-Guided Radiotherapy for Spinal Metastases
| Autor: | Juergen Wilbert, Anne Richter, Kurt Baier, Matthias Guckenberger, Joachim Goebel, Michael Flentje, Reinhart A. Sweeney, Klaus Bratengeier |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Systemic disease medicine.medical_treatment Effective dose (radiation) Myelopathy Life Expectancy medicine Humans Radiology Nuclear Medicine and imaging Spinal canal Child Radiation Injuries Survival rate Aged Retrospective Studies Spinal Neoplasms Radiation medicine.diagnostic_test business.industry Radiotherapy Planning Computer-Assisted Radiotherapy Dosage Retrospective cohort study Magnetic resonance imaging Cone-Beam Computed Tomography Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Survival Rate Radiation therapy Treatment Outcome medicine.anatomical_structure Oncology Female Radiotherapy Intensity-Modulated business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 75:828-835 |
| ISSN: | 0360-3016 |
| Popis: | Purpose To evaluate the outcomes after dose-escalated radiotherapy (RT) for spinal metastases and paraspinal tumors. Methods and Materials A total of 14 patients, 12 with spinal metastases and a long life expectancy and 2 with paraspinal tumors, were treated for 16 lesions with intensity-modulated, image-guided RT. A median biologic effective dose of 74 Gy 10 (range, 55–86) in a median of 20 fractions (range, 3–34) was prescribed to the target volume. The spinal canal was treated to 40 Gy in 20 fractions using a second intensity-modulated RT dose level in the case of epidural involvement. Results After median follow-up of 17 months, one local recurrence was observed, for an actuarial local control rate of 88% after 2 years. Local control was associated with rapid and long-term pain relief. Of 11 patients treated for a solitary spinal metastasis, 6 developed systemic disease progression. The actuarial overall survival rate for metastatic patients was 85% and 63% after 1 and 2 years, respectively. Acute Grade 2-3 skin toxicity was seen in 2 patients with no late toxicity greater than Grade 2. No radiation-induced myelopathy was observed. Conclusion Dose-escalated irradiation of spinal metastases was safe and resulted in excellent local control. Oligometastatic patients with a long life expectancy and epidural involvement are considered to benefit the most from fractionated RT. |
| Databáze: | OpenAIRE |
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