The evolution and rise of stereotactic body radiotherapy (SBRT) for spinal metastases

Balamurugan A. Vellayappan, Samuel T. Chao, Matthew Foote, Matthias Guckenberger, Kristin A Redmond, Eric L. Chang, Nina A. Mayr, Arjun Sahgal, Simon S. Lo

Research output: Contribution to journalReview article

Abstract

Introduction: Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This leads to improved efficacy, shortened treatment schedule, and potentially reduced treatment-related toxicity. Areas covered: In this review, we will look at the progress made by stereotactic body radiotherapy (SBRT) in the management of SM. We will review the technological factors which have enabled the widespread use of SBRT. The efficacy of SBRT, in various clinical scenarios, and associated toxicities will be reviewed. Lastly, we will discuss about patient selection and provide a five-year roadmap. Expert commentary: Spine SBRT is a safe and efficacious treatment option. Practice guidelines recommend the use of SBRT in oligometastatic patients especially those with radio-resistant cancer types, and in scenarios involving re-irradiation. SBRT offers patients dose-intensification over a short schedule which may allow less time off systemic therapy. The results of the phase III trials are eagerly awaited.

Original languageEnglish (US)
Pages (from-to)887-900
Number of pages14
JournalExpert Review of Anticancer Therapy
Volume18
Issue number9
DOIs
StatePublished - Sep 2 2018

Keywords

  • oligo-metastases
  • radiosurgery
  • radiotherapy
  • Spinal metastases
  • stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

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    Vellayappan, B. A., Chao, S. T., Foote, M., Guckenberger, M., Redmond, K. A., Chang, E. L., Mayr, N. A., Sahgal, A., & Lo, S. S. (2018). The evolution and rise of stereotactic body radiotherapy (SBRT) for spinal metastases. Expert Review of Anticancer Therapy, 18(9), 887-900. https://doi.org/10.1080/14737140.2018.1493381