Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions Journal Article

   

Authors:	de Moraes, F. Y.; Taunk, N. K.; Laufer, I.; Neves-Junior, W. F. P.; Hanna, S. A.; Carvalho, H. A.; Yamada, Y.
Article Title:	Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions
Abstract:	Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and nonrandomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. © 2016 CLINICS.
Keywords:	clinical trial; stereotactic body radiotherapy; spine metastasis; sbrt; spine radiosurgery; image-guided radiotherapy; spine tumors
Journal Title:	Clinics
Volume:	71
Issue:	2
ISSN:	1807-5932
Publisher:	Universidade de Sao Paulo
Date Published:	2016-02-01
Start Page:	101
End Page:	109
Language:	English
DOI:	10.6061/clinics/2016(02)09
PROVIDER:	scopus
PMCID:	PMC4760359
PUBMED:	26934240
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84959340157&partnerID=40&md5=556b457a5697227db586afd9046fa710
Notes:	Review -- Export Date: 4 April 2016 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/90341