PMID- 35393978
OWN - NLM
STAT- MEDLINE
DCOM- 20220425
LR  - 20230903
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 45
IP  - 5
DP  - 2022 May 1
TI  - Stereotactic Body Radiation Therapy (SBRT) for Spinal Metastases: Real-world 
      Outcomes From an International Multi-institutional SBRT Registry.
PG  - 196-201
LID - 10.1097/COC.0000000000000909 [doi]
AB  - OBJECTIVE: The objective of this study was to compare clinical outcomes following 
      single fraction versus fractionated stereotactic body radiotherapy (SBRT) for 
      spinal metastases. MATERIALS AND METHODS: A multi-institutional registry was 
      queried for patients with spinal metastases treated with single-fraction or 
      fractionated SBRT. Potential predictive factors of local control (LC) and overall 
      survival were evaluated. Pretreatment and posttreatment Visual Analog Scale 
      scores were analyzed to examine initial and durable pain responses and complete 
      response (CR) rates. Logistic regression was utilized to assess potential 
      correlations between pain response, biologically effective dose (BED), and 
      fractionation. RESULTS: Four hundred sixty-six patients with 514 lesions treated 
      with SBRT were identified; 209 and 104 lesions had information on LC and pain, 
      respectively. The median pain score of patients with symptoms was 6 (range: 3 to 
      10). The median follow-up was 8.9 months (range: 0.4 to 125.5 mo). Utilizing 
      Karnofsky Performance Score, age, and primary site (lung and/or nonbreast), 
      1-year overall survival rates were 76.1%, 59.1%, 54.9%, 37.2%, and 23.5% for 
      patients with 0 to 4 of these factors, respectively (P<0.0001). One- and 2-year 
      LC rates were 79.9% and 73.6%, respectively. Eighty-six patients (82.7%) had an 
      initial pain response with a median decline of 3.5 and a CR rate of 47.1%. 
      Sixty-five patients (62.5%) had a durable pain response with a median decline of 
      2 and a CR rate of 20.2%. Higher initial CR rates were observed with BED10 
      >/=51 Gy10 (58.7% vs. 37.9%; P=0.04). CONCLUSIONS: Following SBRT, encouraging 
      palliative responses with >80% and 60% of patients having initial and durable 
      pain responses, respectively. Dose escalation may result in improved initial CR 
      rates. Performance status, age, and primary histology are factors to consider in 
      the absence of pain.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Singh, Raj
AU  - Singh R
AD  - Department of Radiation Oncology, Virginia Commonwealth University Health System, 
      Richmond, VA.
FAU - Valluri, Anisha
AU  - Valluri A
AD  - Marshall University Joan C. Edwards School of Medicine.
FAU - Jenkins, Jan
AU  - Jenkins J
AD  - The Radiosurgery Society, Sunnyvale, CA.
FAU - Davis, Joanne
AU  - Davis J
AD  - The Radiosurgery Society, Sunnyvale, CA.
FAU - Vargo, John A
AU  - Vargo JA
AD  - Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Center, 
      Pittsburgh, PA.
FAU - Sharma, Sanjeev
AU  - Sharma S
AD  - Department of Radiation Oncology, St. Mary's Medical Center, Huntington, WV.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220408
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
SB  - IM
MH  - Follow-Up Studies
MH  - Humans
MH  - Pain
MH  - *Radiosurgery
MH  - Registries
MH  - *Spinal Neoplasms/radiotherapy/secondary
COIS- The authors declare no conflicts of interest.
EDAT- 2022/04/09 06:00
MHDA- 2022/04/26 06:00
CRDT- 2022/04/08 08:47
PHST- 2022/04/09 06:00 [pubmed]
PHST- 2022/04/26 06:00 [medline]
PHST- 2022/04/08 08:47 [entrez]
AID - 00000421-202205000-00003 [pii]
AID - 10.1097/COC.0000000000000909 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2022 May 1;45(5):196-201. doi: 10.1097/COC.0000000000000909. 
      Epub 2022 Apr 8.