Clinical outcomes after reirradiation of paraspinal tumors Journal Article
| Authors: | Wright, J. L.; Lovelock, D. M.; Bilsky, M. H.; Toner, S.; Zatcky, J.; Yamada, Y. |
| Article Title: | Clinical outcomes after reirradiation of paraspinal tumors |
| Abstract: | OBJECTIVE: We present our experience with reirradiation of locally recurrent paraspinal tumors using image-guided intensity modulated radiotherapy (IG-IMRT). METHODS: We performed a retrospective review of 37 patients who were reirradiated using IG-IMRT for recurrent paraspinal tumors between 2000 and 2005. We evaluated radiation dose to the spinal cord or cauda equina in first and second radiation treatments, time to first recurrence, and clinical outcomes after reirradiation including second recurrence, survival, pain, functional status, and toxicity. RESULTS: Median time to local failure after first radiation was 13 months. All patients underwent salvage reirradiation, postoperatively or with IG-IMRT alone. Median radiation dose to the planning target volume (PTV) was 2000 cGy; median spinal cord or cauda equina dose was 990 cGy. Median cumulative spinal cord or cauda equina dose was 4198 cGy. Local control probability at a median follow-up of 8 months was 60%; median interval to second failure was 13 months. Survival probability at a median follow up of 12 months was 72%; median survival was 18 months. Thirty-four patients (91%) reported stable or improved pain after second radiation, and 26 (70%) had a stable or improved functional status. Mild acute toxicity occurred in 3 patients (8%). No long-term toxicity has been identified. CONCLUSIONS: Reirradiation using IG-IMRT is safe and achieves a meaningful interval of local control with improved symptoms. Further studies with more patients and longer follow up are needed to evaluate toxicity, predictors of failure, and timing of radiation after surgical salvage. © 2006 Lippincott Williams & Wilkins, Inc. |
| Keywords: | adult; clinical article; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; cancer surgery; survival rate; treatment failure; retrospective studies; clinical feature; cancer radiotherapy; radiation dose; follow up; palliative care; neoplasm recurrence, local; cancer pain; radiation injury; retrospective study; imrt; radiotherapy, intensity-modulated; tumor recurrence; device; spinal cord tumor; spinal neoplasms; patient safety; radiotherapy planning, computer-assisted; cancer control; retreatment; functional status; immobilization; image-guided; reirradiation; cauda equina; paraspinal; image guided intensity modulated radiotherapy |
| Journal Title: | American Journal of Clinical Oncology |
| Volume: | 29 |
| Issue: | 5 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2006-10-01 |
| Start Page: | 495 |
| End Page: | 502 |
| Language: | English |
| DOI: | 10.1097/01.coc.0000227559.32799.db |
| PUBMED: | 17023786 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 14" - "Export Date: 4 June 2012" - "CODEN: AJCOD" - "Source: Scopus" |
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