ESTRO 2024 - Abstract Book

S1902

Clinical - Mixed sites, palliation

ESTRO 2024

Keywords: Immunotherapy, non-irradiated, abscopal effect

1189

Proffered Paper

SBRT vs. Conventional Radiotherapy for Painful Spinal Metastases: Randomised Phase 3 Trial

Matthias Guckenberger 1,2 , Charlotte Billeit 3 , Daniel Schnell 4 , Ciro Franzese 5 , Mateusz Spałek 6 , Susanne Rogers 7 , Jean Jacques Stelmes 8,9 , Daniel Aebersold 10,11 , Hossein Hemmatazad 10 , Frank Zimmermann 12 , Jörg Zimmer 13 , Thomas Zilli 8,14 , Alessio Bruni 15 , Brigitta G. Baumert 16 , Franziska Nägler 17 , Philipp Gut 18 , Robert Förster 1,19 , Indira Madani 1 1 University Hospital Zurich, Radiation Oncology, Zurich, Switzerland. 2 University of Zurich, Faculty of Medicine, Zurich, Switzerland. 3 Iridium Netwerk, Wilrijk, University of Antwerp, Radiation Oncology, Antwerp, Belgium. 4 University Hospital Freiburg, Radiation Oncology, Freiburg, Germany. 5 Humanitas Clinical Institute, Radiation Oncology, Milan, Italy. 6 Maria Sklodowska-Curie National Research Institute of Oncology, Radiation Oncology, Warsaw, Poland. 7 Kantonsspital Aarau, Radiation Oncology, Aarau, Switzerland. 8 Ente Ospedaliero Cantonale, Radiation Oncology, Bellinzona, Switzerland. 9 Ministry of Public Health, Luxemburg Health Directorate, Luxemburg, Luxembourg. 10 Inselspital, Bern University Hospital, Radiation Oncology, Bern, Switzerland. 11 University of Bern, Faculty of Medicine, Bern, Switzerland. 12 University Hospital Basel, Radiation Oncology, Basel, Switzerland. 13 Städtisches Klinikum Dresden, Radiation Oncology, Dresden, Germany. 14 Geneva University Hospital, Radiation Oncology, Geneva, Switzerland. 15 University Hospital of Modena, Radiation Oncology, Modena, Italy. 16 Kantonsspital Graubunden, Radiation Oncology, Chur, Switzerland. 17 University Hospital Leipzig, Radiation Oncology, Leipzig, Germany. 18 Hirslanden Clinic, Radiation Oncology, Zurich, Switzerland. 19 Kantonsspital Winterthur, Radiation Oncology, Winterthur, Switzerland

Purpose/Objective:

To compare pain relief with dose-intensifed image-guided fractionated stereotactc body radiotherapy (SBRT) versus conventional external beam radiotherapy (cEBRT) in patients with painful spinal metastases.

Material/Methods:

Patients with 1- 2 distinct painful radiologically confirmed spinal metastases, a Spinal Instability Neoplastic Score ≤12 and a Karnofsky performance status ≥60 were eligible for this open -label, multicenter, randomized, controlled phase 3 trial (ClinicalTrials.gov Identifier: NCT02800551). Patients were randomly assigned to receive either dose intensified SBRT (40 Gy/5 or 48.5 Gy/10 to the high-dose target volume, without or with epidural involvement, respectively) or cEBRT (30 Gy/10 or 20 Gy/5). The primary end- point was improvement in pain score by ≥2 points on the zero-to-ten Visual Analogue Scale (VAS) at 6 months post-treatment at the treatment site. Data were analyzed intent-to-treat and per-protocol.

Results: