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Patterns of Failure After Stereotactic Body Radiotherapy to Sacral Metastases.
R Ratnakumaran1, N van As1, V Khoo1
1The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|February 22, 2023
Summary
Stereotactic body radiotherapy (SBRT) for sacral metastases shows excellent local control. Adhering to the consensus contouring recommendation (CCR) could potentially prevent rare cases of sacral relapse.
Area of Science:
- Radiation Oncology
- Medical Physics
- Oncology
Background:
- Stereotactic body radiotherapy (SBRT) is a growing treatment for sacral metastases.
- Assessing local relapse and failure patterns is crucial for optimizing SBRT protocols.
- The consensus contouring recommendation (CCR) provides guidelines for treatment field margins.
Purpose of the Study:
- To analyze local relapse rates and failure patterns following sacral SBRT.
- To evaluate if adherence to the CCR could have prevented local relapses.
- To determine the effectiveness of SBRT in managing sacral metastases.
Main Methods:
- Retrospective review of 34 patients treated with sacral SBRT (2012-2021).
- Analysis of local relapse, patterns of failure, and overall survival.
- Review of planning CT and relapse imaging to assess CCR applicability.
Main Results:
- Excellent local control was achieved with sacral SBRT.
- The cumulative incidence of local relapse at 2 years was 16.8%.
- Most cases (85.3%) deviated from CCR; one relapse (2.9%) might have been preventable with CCR.
Conclusions:
- Sacral SBRT demonstrates high efficacy in local tumor control.
- While rare, sacral relapse can occur, and CCR adherence may offer preventative benefits.
- Current SBRT practices, often using margin expansion, yield favorable outcomes.
