Stereotactic Body Radiation Therapy for Spinal Metastases: Benefits and Limitations.

Progress in biological cancer characterization, targeted systemic therapies and multimodality treatment strategies have shifted the goals of radiotherapy for spinal metastases from short-term palliation to long-term symptom control and prevention of compilations. This article gives an overview of the spine stereotactic body radiotherapy (SBRT) methodology and clinical results of SBRT in cancer patients with painful vertebral metastases, metastatic spinal cord compression, oligometastatic disease and in a reirradiation situation. Outcomes after dose-intensified SBRT are compared with results of conventional radiotherapy and patient selection criteria will be discussed. Though rates of severe toxicity after spinal SBRT are low, strategies to minimize the risk of vertebral compression fracture, radiation induced myelopathy, plexopathy and myositis are summarized, to optimize the use of SBRT in multidisciplinary management of vertebral metastases.

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Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest Matthias Guckenberger: None. Max Dahele: Research funding and honorarium from Varian Medical Systems. Wee Loon Ong: None. Arjun Sahgal: Consultant with Varian (Medical Advisory Group), Elekta (Gamma Knife Icon), BrainLAB, Merck, Abbvie, Roche; Past educational seminars (honorarium) with AstraZeneca, Elekta AB, Varian (CNS Teaching Faculty), BrainLAB, Medtronic Kyphon, Accuray, Seagen Inc.; Research Grant: Elekta AB, Varian, Seagen Inc.; Travel accommodations/expenses: Elekta, Varian, BrainLAB.