ESTRO 2024 - Abstract Book

S1936

Clinical - Mixed sites, palliation

ESTRO 2024

Association Impairment Scale (ASIA), patient reported neck motion (classified into full range of motion (ROM), minor limitations in ROM, major limitations in ROM, not reported and early removal), Karnofsky Performance Score (KPS), and semi-quantitative assessment of reossification on CT-scan or radiograph of the cervical spine.

Results:

The majority of metastatic lesions originated from a radiosensitive primary tumor (n=15), including breast (n=6), multiple myeloma (n=5) and prostate (n=4). The average age at start of treatment was 62 years old (range, 45-82 years) and 11 patients were female. The median period of immobilization with halo-fixation was 83 days (range, 41 132 days). In 3 patients the halo frame was removed earlier due to rapidly progressive disease, and one patient died due to perforated diverticulitis 43 days after start of treatment. Radiotherapy started on average 7 days after halo fixation (range, -35-188 days). The majority of patients were treated with longer radiation schedules (10 patients received 10 x 3 Gray), to increase the chance of reossification. The median pain score at baseline was 8, at halo removal and last follow up it was 0 and 0, respectively. All patients had no or minor neurological impairment (ASIA E or non-progressive ASIA D) at baseline and did not develop neurological deficits during treatment. The median KPS at baseline was 70, which improved or remained stable in 15/18 patients at halo removal. At halo removal, the majority of patients experienced some or substantial reossification (17/18), in 2 patients the halo frame was removed before imaging was obtained to assess reossification due to rapidly progressive disease. The majority of patients experienced full ROM or minor limitations in ROM at last follow-up. The pathological fracture of the odontoid remained unstable in one patient after treatment with halo fixation followed by radiotherapy and this patient underwent a spondylodesis of C1-C4, 112 days after radiotherapy.

Conclusion:

In selected patients with unstable cervical metastases without neurological deficits, temporary halo-fixation combined with (long course) radiotherapy appears to be an attractive alternative to long-construct spinal fixations. The majority of patients showed some or substantial reossification, clear pain reduction, and functional range of neck motion after halo frame removal with sustained results at long term follow-up.

Keywords: Cervical metastases, Halo-fixation, radiotherapy

1682

Digital Poster

STEREOTACTIC BODY RADIOTHERAPY (SBRT) FOR ADRENAL METASTASIS: A SINGLE CENTER EXPERIENCE

Carlos Camacho Fuentes 1 , Javier Luna Tirado 1 , Ana B Morcillo García 2 , Laura P Guzmán Gómez 1 , Claudia M Díaz Silvera 1 , Walter A Vásquez Rivas 1 , Marta Pérez Cobos 1 , Ignacio Navarro Ruiz de Adana 1 , Leticia Del Campo Rodríguez Ponga 1 , Ignacio Azinovic Gamo 1 1 Hospital Universitario Fundación Jiménez Díaz, Radiation Oncology, Madrid, Spain. 2 Hospital Universitario Fundación Jiménez Díaz, Radiation Physicists, Madrid, Spain