PMID- 30003994
OWN - NLM
STAT- MEDLINE
DCOM- 20190529
LR  - 20220408
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 102
IP  - 3
DP  - 2018 Nov 1
TI  - Imaging-Based Outcomes for 24 Gy in 2 Daily Fractions for Patients with de Novo 
      Spinal Metastases Treated With Spine Stereotactic Body Radiation Therapy (SBRT).
PG  - 499-507
LID - S0360-3016(18)31048-4 [pii]
LID - 10.1016/j.ijrobp.2018.06.047 [doi]
AB  - PURPOSE: We report mature outcomes for a cohort of patients with no prior 
      radiation (de novo) to the spine treated with 24 Gy in 2 daily fractions for 
      metastases, which represents the same stereotactic body radiation therapy (SBRT) 
      regimen under evaluation in the current Symptom Control-24 phase 3 randomized 
      trial (NCT02512965). METHODS AND MATERIALS: The cohort consisted of 279 de novo 
      spinal metastases in 145 consecutive patients treated with 24 Gy in 2 SBRT 
      fractions, identified from a prospective single-institution database. The 
      endpoints were overall survival (OS), imaging-based local failure (LF), and 
      cumulative risk of vertebral compression fractures (VCF). RESULTS: The median 
      follow-up per treated metastasis was 15.0 months (range, 0.1-71.6). The 1-year 
      and 2-year OS rates were 73.1% and 60.7%, respectively. Presence of epidural 
      disease (P < .0001), lung (P = .0415), and renal cell (P < .0001) primary 
      histologies and baseline diffuse metastases (P = .0034) were significant 
      prognostic factors for OS. The 1-year and 2-year LF rates were 9.7% and 17.6%, 
      respectively, and the median time to LF was 9.2 month (range, 0.4-31.3 months). 
      Only the presence of epidural disease predicted for LF (P < .0001). The 
      cumulative risk of VCF at 1 and 2 years was 8.5% and 13.8%, respectively. Lytic 
      (P = .0143) or mixed lytic/blastic (P = .0214) lesions, spinal malalignment 
      (P = .0121), and the dose to 90% of the planning target volume (P = .0085) were 
      significant predictors for VCF. CONCLUSIONS: Twenty-four Gray in 2 daily 
      fractions is safe and effective in achieving high tumor control rates for de novo 
      spinal metastases. These outcomes will serve as a benchmark for the ongoing 
      Symptom Control-24 randomized trial comparing 24 Gy in 2 SBRT fractions to 20 Gy 
      delivered in 5 daily conventional fractions.
CI  - Copyright (c) 2018 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Tseng, Chia-Lin
AU  - Tseng CL
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada. Electronic address: chia-lin.tseng@sunnybrook.ca.
FAU - Soliman, Hany
AU  - Soliman H
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
FAU - Myrehaug, Sten
AU  - Myrehaug S
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
FAU - Lee, Young K
AU  - Lee YK
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
FAU - Ruschin, Mark
AU  - Ruschin M
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
FAU - Atenafu, Eshetu G
AU  - Atenafu EG
AD  - Department of Biostatistics, University Health Network, University of Toronto, 
      Toronto, Canada.
FAU - Campbell, Mikki
AU  - Campbell M
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
FAU - Maralani, Pejman
AU  - Maralani P
AD  - Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health 
      Sciences Centre, University of Toronto, Toronto, Canada.
FAU - Yang, Victor
AU  - Yang V
AD  - Department of Surgery, Division of Neurosurgery, Sunnybrook Health Sciences 
      Centre, Toronto, Canada.
FAU - Yee, Albert
AU  - Yee A
AD  - Department of Surgery, Division of Orthopaedic Surgery, Sunnybrook Health 
      Sciences Centre, Toronto, Canada.
FAU - Sahgal, Arjun
AU  - Sahgal A
AD  - Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University 
      of Toronto, Toronto, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT02512965
PT  - Journal Article
DEP - 20180710
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Databases, Factual
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Follow-Up Studies
MH  - Fractures, Compression/etiology
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Neoplasm Metastasis
MH  - Outcome Assessment, Health Care
MH  - Proportional Hazards Models
MH  - *Radiosurgery
MH  - Retrospective Studies
MH  - Risk
MH  - Spinal Cord Compression
MH  - Spinal Neoplasms/*radiotherapy/*secondary
MH  - Spine/*pathology
MH  - Treatment Outcome
EDAT- 2018/07/14 06:00
MHDA- 2019/05/30 06:00
CRDT- 2018/07/14 06:00
PHST- 2018/02/08 00:00 [received]
PHST- 2018/06/21 00:00 [revised]
PHST- 2018/06/27 00:00 [accepted]
PHST- 2018/07/14 06:00 [pubmed]
PHST- 2019/05/30 06:00 [medline]
PHST- 2018/07/14 06:00 [entrez]
AID - S0360-3016(18)31048-4 [pii]
AID - 10.1016/j.ijrobp.2018.06.047 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2018 Nov 1;102(3):499-507. doi: 
      10.1016/j.ijrobp.2018.06.047. Epub 2018 Jul 10.