Low incidence of late failure and toxicity after spine stereotactic radiosurgery: Secondary analysis of phase I/II trials with long-term follow-up
| Autor: | Jing Li, Bhavana V. Chapman, Andrew J. Bishop, Claudio E. Tatsui, Xin A. Wang, Paul D. Brown, Jennifer C. Ho, Laurence D. Rhines, Pamela K. Allen, Behrang Amini, Brian J. Deegan, Matthew S. Ning, Tina Marie Briere, Nizar M. Tannir, Amol J. Ghia |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Long term follow up medicine.medical_treatment Population Radiosurgery Logistic regression 030218 nuclear medicine & medical imaging 03 medical and health sciences Clinical Trials Phase II as Topic 0302 clinical medicine Survivorship curve Secondary analysis medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies education Aged education.field_of_study Spinal Neoplasms Clinical Trials Phase I as Topic business.industry Incidence Incidence (epidemiology) Hematology Middle Aged Logistic Models Oncology 030220 oncology & carcinogenesis Toxicity Female Radiology business Follow-Up Studies |
| Zdroj: | Radiotherapy and Oncology. 138:80-85 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2019.06.003 |
| Popis: | Background and purpose To characterize local control and late toxicity in long-term survivors prospectively-treated with spine stereotactic radiosurgery (SSRS). Materials and methods From 2002 to 2011, 228 patients were prospectively-treated on protocol for metastatic disease of 261 vertebral sites. A subset of 52 patients surviving >4 years following treatment were collectively treated for 58 sites (encompassing 69 vertebrae) and underwent secondary analysis. Of all sites, 9% received prior radiation, and 16% encompassed multiple contiguous vertebrae. Radiation prescriptions were most commonly 24 Gy in 1 and 27 Gy in 3 fractions. Outcomes were evaluated via Kaplan–Meier, and associations analyzed via logistic regression. Results Median follow-up was 6.7 years (range: 49–142 months). Five-year local control by site was 91%, with late failures (>2 years) occurring in 3%. Overall and Grade ≥3 late toxicities (>2 years) were observed in 5% and 2% of sites. The last known neurologic event (grade 2 radiculopathy) was noted 2.1 years post-treatment, while the last documented fracture occurred at 4.1 years. No Grade ≥3 events were witnessed after 3.1 years post-SSRS, and no toxicities were noted after 4.1 years through end of follow-up. Re-irradiation, number of segments treated per site (1 vs. 2–3), and fractionation (1 vs. 3–5) were not associated with failure or toxicity. Conclusion SSRS maintains excellent disease control and a favorable late toxicity profile even among long-term survivors, with very few failures or toxicities after 2 years in this prospectively-treated population. Overall, these data support the durable control and long-term safety of SSRS with extended follow-up. |
| Databáze: | OpenAIRE |
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