<p>Single-Fraction Radiotherapy (SFRT) For Bone Metastases: Patient Selection And Perspectives</p>

Abstract

Bone metastases are a frequent and important source of morbidity in cancer patients. Stereotactic body radiation therapy (SBRT) is an established treatment option for local control and pain relief of bone metastases, and it is increasingly used as upfront treatment, postoperative consolidation or salvage treatment after prior RT. However, heterogeneity of dose schedules described in literature represents a severe limitation in the definition of the role of SBRT as a standard of care. No consensus is available on the use of single versus multiple fraction SBRT for bone metastases. Advantages of single-fraction SBRT include shorter overall duration of treatment, absence of inter-fraction uncertainty, improved compliance, theoretical increased efficacy, and lower costs. However, caution has been advised due to reports of severe late toxicities, in particular, vertebral collapse fracture (VCF). The aim of this paper is to review dose fractionation and indications for the management of bone metastases using SBRT.

Efficacy of Total En Bloc Spondylectomy versus Stereotactic Ablative Radiotherapy for Single Spinal Metastasis

“…The oligometastatic state, an intermediate phase between manageable localized disease and inoperable extensive disease, has shown excellent control rates when spinal involvement is treated with SABR [17,18]. This is supported by the findings of recent randomized trials indicating overall survival and progression-free survival benefits compared with conventional radiation therapy [19].…”

Image-Guided High-Intensity Focused Ultrasound, A Novel Application for Interventional Nuclear Medicine?

“…There are many procedures available for treatment. The most common method is radiotherapy at a single fraction of 8 Gy or 30 Gy in 10 fractions; however, a high toxicity rate was reported (30).…”

Biomechanical Properties of Metastatically Involved Osteolytic Bone

“…Radiation therapy is commonly used for treatment of metastatic bone tumours, however in the movement towards localized control with stereotactic body radiotherapy (SBRT), the incidence of post treatment fractures has increased with post SBRT vertebral compression fractures occurring in approximately 11% of patients [3,[115][116][117][118]. As such, the focal impact of SBRT on bone quality [119][120][121] must be considered in the context of treatment planning and patient selection.…”