Radiosurgery as Primary Treatment for Vertebral Metastases: Results From an International Multicenter Database

Abstract

was: Improved or stable 91% and progressive 9%. A dose-response analysis showed that a prescribed dose of EQD2/10 > 33 Gy significantly (p Z 0.003) correlated with pain control as was the cumulative dose of the SRS and EBRT (EQD2/10 > 67; p Z 0.001). Other factors influencing pain response included controlled systemic disease, interval between EBRT and SRS > 12 months, single fraction radiosurgery and a Bilsky score of 0 to 1b. Neurologic deficits were improved or stable in 91% of patients. The ASIA status at the last clinical follow-up was E-78%, D-16%, C-3%, and B-1%. A new vertebral fracture was observed in 2.4% of the SRS courses and progressive spinal fractures were seen in 4.1%. There were no cases of radiation induced myelopathy. Conclusions: Stereotactic spinal radiosurgery following EBRT offers highly promising pain control. Durable local control and neurologic stabilization can be achieved in a retreatment population. With proper treatment planning and delivery, re-irradiation can be safely utilized and offers significant benefits in this patient population. Author Disclosure: C. Kersh: None. J. Sheehan: None. P. Gerszten: None. J. Flickenger: None. A. Sahgal: None. D. Letourneau: None. I. Grills: None. M. Jawad: None. F. Mantel: None. M. Guckenberger: None.