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Long-Term Outcomes After Reirradiation With Spine Stereotactic Body Radiation Therapy: Single-Institutional
J John Lucido1, Trey C Mullikin2, W Scott Harmsen3
1Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Practical Radiation Oncology
|September 5, 2025
Summary
Re-irradiation of spinal metastases using stereotactic body radiotherapy (SBRT) is safe and effective. This study shows good survival and low local failure rates, supporting SBRT for retreatment.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Spinal metastases are common, and re-irradiation is often necessary.
- Limited data exists on outcomes for re-irradiation of spinal metastases with SBRT.
- Clinical decision-making is challenged by a lack of evidence.
Purpose of the Study:
- To evaluate the safety and effectiveness of re-irradiating spinal metastases using SBRT.
- To analyze patient outcomes, including survival, local control, and adverse events.
- To provide data to guide clinical practice for spine re-irradiation.
Main Methods:
- Retrospective analysis of 107 lesions in 91 patients treated with SBRT re-irradiation.
- Detailed review of prior conventional radiotherapy doses and time intervals.
- Analysis of SBRT fractionation schemes and delivered doses.
- Assessment of overall survival, local failure, vertebral compression fracture, and radiation-induced toxicities.
Main Results:
- One-year overall survival was 61%.
- Cumulative incidence of local failure was 12% and vertebral compression fracture was 9%.
- No radiation myelitis observed for lesions at or above L1; chronic peripheral neuropathy occurred in 5 patients.
Conclusions:
- Spine re-irradiation with SBRT is a safe and effective treatment option.
- Adverse events and local failures predominantly occur within two years post-treatment.
- Findings support the use of SBRT for re-irradiation of spinal metastases.
