Stereotactic body radiotherapy for intramedullary metastases: a retrospective series at the Oscar Lambret center and a systematic review.
Adenocarcinoma
/ radiotherapy
Adenocarcinoma of Lung
/ radiotherapy
Adult
Aged
Breast Neoplasms
/ pathology
Cancer Care Facilities
Carcinoma, Renal Cell
/ radiotherapy
Dose Fractionation, Radiation
Female
Follow-Up Studies
France
Humans
Kidney Neoplasms
/ pathology
Lung Neoplasms
/ pathology
Male
Melanoma
/ radiotherapy
Middle Aged
Progression-Free Survival
Radiosurgery
Retrospective Studies
Skin Neoplasms
/ pathology
Spinal Cord Neoplasms
/ diagnostic imaging
Tumor Burden
Intramedullary metastasis
Neuro-oncology
Radiosurgery
Radiotherapy
SBRT
Stereotactic
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
30 Oct 2021
30 Oct 2021
Historique:
received:
13
07
2021
accepted:
14
10
2021
entrez:
31
10
2021
pubmed:
1
11
2021
medline:
8
2
2022
Statut:
epublish
Résumé
Intramedullary metastasis (IMM) is a rare disease with poor prognosis. The incidence of IMMs has increased, which has been linked to improved systemic treatment in many cancers. Surgery and/or radiotherapy are the most commonly used treatments; only small-sample retrospective studies and case reports on stereotactic body radiotherapy (SBRT) have reported acceptable results in terms of local control and clinical improvement, with no reported toxicity. Thus, we performed this monocentric retrospective study on five cases treated with SBRT for IMMs, which we supplemented with a systematic review of the literature. We included all patients treated for IMM with SBRT. The target tumor volume, progression-free survival, prescription patterns in SBRT, survival without neurological deficit, neurological functional improvement after treatment, and overall survival were determined. Five patients treated with a median dose of 30 Gy in a median number of fractions of 5 (prescribed at a median isodose of 86%) included. The median follow-up duration was 23 months. Two patients showed clinical improvement. Three patients remained stable. Radiologically, 25% of patients had complete response and 50% had stable disease. No significant treatment-related toxicity was observed. SBRT appears to be a safe, effective, and rapid treatment option for palliative patients.
Sections du résumé
BACKGROUND
BACKGROUND
Intramedullary metastasis (IMM) is a rare disease with poor prognosis. The incidence of IMMs has increased, which has been linked to improved systemic treatment in many cancers. Surgery and/or radiotherapy are the most commonly used treatments; only small-sample retrospective studies and case reports on stereotactic body radiotherapy (SBRT) have reported acceptable results in terms of local control and clinical improvement, with no reported toxicity. Thus, we performed this monocentric retrospective study on five cases treated with SBRT for IMMs, which we supplemented with a systematic review of the literature.
METHODS
METHODS
We included all patients treated for IMM with SBRT. The target tumor volume, progression-free survival, prescription patterns in SBRT, survival without neurological deficit, neurological functional improvement after treatment, and overall survival were determined.
RESULTS
RESULTS
Five patients treated with a median dose of 30 Gy in a median number of fractions of 5 (prescribed at a median isodose of 86%) included. The median follow-up duration was 23 months. Two patients showed clinical improvement. Three patients remained stable. Radiologically, 25% of patients had complete response and 50% had stable disease. No significant treatment-related toxicity was observed.
CONCLUSION
CONCLUSIONS
SBRT appears to be a safe, effective, and rapid treatment option for palliative patients.
Identifiants
pubmed: 34717570
doi: 10.1186/s12885-021-08901-6
pii: 10.1186/s12885-021-08901-6
pmc: PMC8557534
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1168Informations de copyright
© 2021. The Author(s).
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