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Risk-adapted stereotactic body radiotherapy for patients with cervical spinal metastases
Huan-Huan Wang1, Shou-Sen Tian1, Jia-Min Yang1
1Department of Radiotherapy and CyberKnife Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin, China.
Cancer Science
|September 3, 2022
Summary
Stereotactic body radiotherapy (SBRT) effectively manages cervical spine metastases, offering significant pain relief and high local control rates. This advanced treatment demonstrates acceptable safety, making it a viable option for patients with this complex condition.
Area of Science:
- Oncology
- Radiation Oncology
- Neurosurgery
Background:
- Cervical spinal metastases present complex anatomical and biomechanical challenges.
- Standard palliative treatments have high recurrence and complication rates.
- Stereotactic body radiotherapy (SBRT) offers precise tumor targeting and organ sparing, but its efficacy for cervical metastases is not well-established.
Purpose of the Study:
- To evaluate the efficacy and safety of risk-adapted Stereotactic Body Radiotherapy (SBRT) for cervical spine metastases.
- To assess pain response, local control (LC), overall survival (OS), and adverse events following SBRT.
Main Methods:
- Retrospective analysis of 71 patients with cervical spine metastases treated with CyberKnife SBRT (2006-2021).
- Risk-adapted fractionation schedules based on spinal cord and esophagus dose constraints.
- Primary endpoint: pain response at 12 weeks; secondary endpoints: LC, OS, adverse events.
Main Results:
- 98.2% of patients with baseline pain achieved pain response, with 83.6% achieving complete response at 12 weeks.
- 1-year and 2-year local control rates were 93.1% and 90%, respectively.
- 1-year and 2-year overall survival rates were 66.2% and 37.4%.
- Adverse events included vertebral compression fractures (VCF) and hemiparesis; no grade 5 events occurred.
Conclusions:
- Risk-adapted SBRT is an effective treatment for cervical spine metastases.
- High rates of pain control and local control were achieved with SBRT.
- SBRT demonstrated an acceptable safety profile for managing cervical spine metastases.
