2019
DOI: 10.3389/fonc.2019.00337
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Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview

Abstract: The oligometastatic state is hypothesized to represent an intermediary state of cancer between widely metastatic disease and curable, localized disease. Advancements in radiotherapy have allowed for delivery of high precision, dose escalated treatment known as stereotactic body radiotherapy (SBRT) to targets throughout the body with excellent rates of local control. Recently, the first phase II randomized trial comparing conventional radiotherapy to comprehensive SBRT of oligometastatic disease demonstrated an… Show more

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Cited by 86 publications
(65 citation statements)
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“…As an alternative, stereotactic body RT (SBRT) allows for the delivery of ablative doses to small volumes with a steep dose gradient to spare surrounding normal structures. Although SBRT is increasingly used in adult patients for the treatment of oligometastatic disease, 36‐44 to our knowledge there are limited data regarding its safety and efficacy in a pediatric population 45,46 . There is a particularly strong rationale for SBRT in this population as a strategy to reduce dose to nontarget tissues and potentially reduce the late effects of RT.…”
Section: Introductionmentioning
confidence: 99%
“…As an alternative, stereotactic body RT (SBRT) allows for the delivery of ablative doses to small volumes with a steep dose gradient to spare surrounding normal structures. Although SBRT is increasingly used in adult patients for the treatment of oligometastatic disease, 36‐44 to our knowledge there are limited data regarding its safety and efficacy in a pediatric population 45,46 . There is a particularly strong rationale for SBRT in this population as a strategy to reduce dose to nontarget tissues and potentially reduce the late effects of RT.…”
Section: Introductionmentioning
confidence: 99%
“…The safety and efficacy of stereotactic body radiotherapy (SBRT) for spinal metastases have been demonstrated in retrospective and prospective phase I/II trials, showing higher rates of local control and faster and longer pain relief [5][6][7][8][9]. The issue is of particular relevance in oligometastatic patients even due to the potentially relevant impact on the oncological outcome [5,8,9] Given the delivery of high doses in a small number of fractions (typically 1-5) and the proximity of the spinal cord dose distributions with steep dose gradients outside the planning target volume (PTV) need to be delivered. Consequently, in order to avoid potential adverse effects [10][11][12][13], sufficiently high geometric accuracy is required.…”
Section: Introductionmentioning
confidence: 99%
“…Higher doses and individualized treatments have been recommended in this patient setting. The safety and efficacy of stereotactic body radiotherapy (SBRT) for spinal metastases have been demonstrated in retrospective and prospective phase I/II trials, showing higher rates of local control and faster and longer pain relief [5] , [6] , [7] , [8] , [9] . The issue is of particular relevance in oligometastatic patients even due to the potentially relevant impact on the oncological outcome [5] , [8] , [9] …”
Section: Introductionmentioning
confidence: 99%
“…5 Single institution studies demonstrate an advantage of using SRS/SBRT in terms of increased local control and complete response compared to conventional three-dimensional conformal radiotherapy (3DCRT). [6][7][8][9][10][11][12][13] Sprave et al 14 3 (none of which were spine) of 66 the patients after SABR, compared to none (n = 33) in the control group. 15 The most feared complication from spine SRS is radiation myelopathy.…”
Section: Introductionmentioning
confidence: 98%