ESTRO 2024 - Abstract Book

S1930

Clinical - Mixed sites, palliation

ESTRO 2024

1548

Digital Poster

Outcomes of postsurgical spine SBRT. A radical therapy for spinal cord compression

Héctor Pérez-Montero 1 , Óscar Godino 2 , Luis López 2 , Yuan Lin 1 , María Arántzazu Mera 3 , Arturo Navarro-Martin 4

1 Institut Català d'Oncologia, Radiation Oncology, Barcelona, Spain. 2 Hospital Universitari de Bellvitge, Neurosurgery, Barcelona, Spain. 3 Hospital de la Santa Creu i Sant Pau, Radiation Oncology, Barcelona, Spain. 4 Hospital Sant Pau, Radiation Oncology, Barcelona, Spain

Purpose/Objective:

Spinal cord compression (SCC) is a prevalent oncological complication. Radiotherapy has classically played a palliative role in its management. However, in oligometastatic patients with a good prognosis, a radical approach could be considered.

Material/Methods:

In this study, we retrospectively report our experience in patients treated with stereotactic body radiation therapy (SBRT) after surgery for SCC. Toxicity and survival were analyzed.

Results:

Between 2019-2022 we have treated 8 patients (7 female/1 male) diagnosed with SCC using this approach. Median age: 57.7 years. The primary tumor was breast in 62.5% of cases. All cases were oligometastatic evaluated by MRI and PET (median SUVmax: 9.1). Spine location was dorsal in 75%, and 87.5% were lytic metastases. The Bilsky scale was 1A (3 cases), 1C (2 cases), or 2 (3 cases). Stabilization +/- oncological surgery was performed in all patients. Residual epidural tumor component remained in 75% of cases. SBRT was performed in 5 fractions on alternate days (total dose 23.5-35Gy). Median GTV: 8.1 cm3. 75% of cases received prophylactic corticotherapy. Patient, tumor and treatment characteristics are shown in Table 1. The median follow-up was 21.5 months. 2 cases of limited acute esophagitis (G1-2) were observed. 1 local progression and 1 death were reported in two patients. Mean local control (LC) and overall survival (OS) were 30.9 and 31.7 months respectively. 2-year LC and OS were 80% and 85.7% respectively.