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Primary Stereotactic Body Radiation Therapy for Breast Cancer Spinal Metastases.
Kuan-Nien Chou1, David J Park2, Yusuke S Hori2
1Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA; Department of Neurological surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (R.O.C).
Clinical Breast Cancer
|March 23, 2025
Summary
Stereotactic body radiation therapy (SBRT) effectively treats breast cancer spinal bone metastases (SBM). Careful treatment planning is crucial for optimizing outcomes and minimizing adverse events in patients receiving SBRT for SBM.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Breast cancer frequently metastasizes to the spine (SBM).
- Stereotactic body radiation therapy (SBRT) is an emerging primary treatment for SBM.
- A decade of experience with SBRT for breast cancer SBM provides valuable insights.
Purpose of the Study:
- To evaluate the efficacy and safety of SBRT as a primary intervention for breast cancer spinal bone metastases.
- To identify factors influencing local control and adverse events.
- To assess long-term outcomes of SBRT for breast cancer SBM.
Main Methods:
- Retrospective analysis of patients treated with primary SBRT (CyberKnife System) for breast cancer SBM from March 2012 to January 2023.
- Inclusion of 47 female patients with 82 SBMs across 104 vertebrae.
- Analysis of local control rates, local progression, and adverse events.
Main Results:
- Overall local control rate of 84.1% for primary SBRT in breast cancer SBM.
- 1-, 3-, and 5-year local progression rates were 9.7%, 13.3%, and 18.3%, respectively.
- Factors associated with increased local progression included invasive lobular carcinoma and lower revised Tokuhashi scores. Adverse events were linked to advanced age and suboptimal target coverage.
Conclusions:
- SBRT using the CyberKnife System is an effective primary treatment for breast cancer spinal bone metastases.
- Optimized treatment planning is essential for maximizing therapeutic benefits and minimizing adverse events.
- Further research into predictive factors for treatment response and toxicity is warranted.
