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Volumetric Intensity-Modulated Arc Stereotactic Radiosurgery Boost in Oligometastatic Patients with Spine Metastases: a Dose-escalation Study
- Source :
- Clinical Oncology. 35:e30-e39
- Publication Year :
- 2023
- Publisher :
- Elsevier BV, 2023.
-
Abstract
- To report the final results of a dose-escalation study of volumetric intensity-modulated arc stereotactic radiosurgery (VMAT-SRS) boost after three-dimensional conformal radiation therapy in patients with spine metastases.Oligometastatic cancer patients bearing up to five synchronous metastases (visceral or bone, including vertebral ones) and candidates for surgery or radiosurgery were considered for inclusion. 25 Gy was delivered in 10 daily fractions (2 weeks) to the metastatic lesion, affected vertebrae and adjacent ones (one cranial and one caudal vertebra). Sequentially, the dose to spinal metastases was progressively increased (8 Gy, 10 Gy, 12 Gy) in the patient cohorts. Dose-limiting toxicities were defined as any treatment-related non-hematologic acute adverse effects rated as grade ≥3 or any acute haematological toxicity rated as ≥ 4 by the Radiation Therapy Oncology Group scale.Fifty-two lesions accounting for 40 consecutive patients (male/female: 29/11; median age: 71 years; range 40-85) were treated from April 2011 to September 2020. Most patients had a primary prostate (65.0%) or breast cancer (22.5%). Thirty-two patients received 8 Gy VMAT-SRS boost (total BEDA 12 Gy spine metastasis SRS boost following 25 Gy to the affected and adjacent vertebrae was feasible with an excellent local control rate and toxicity profile.
- Subjects :
- Male
Adult
Aged, 80 and over
Spinal Neoplasms
Breast Neoplasms
Middle Aged
Radiosurgery
Magnetic Resonance Imaging
spinal metastases
volumetric arc radiotherapy
stereotactic body radiotherapy
Oncology
Humans
Female
Radiology, Nuclear Medicine and imaging
Radiotherapy, Intensity-Modulated
Radiotherapy, Conformal
Tomography, X-Ray Computed
Oligometastases
vertebral compression fracture
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Aged
Subjects
Details
- ISSN :
- 09366555
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Clinical Oncology
- Accession number :
- edsair.doi.dedup.....a0c2e3e8ba16a85800a6458bbe41c8fb