ESTRO 2024 - Abstract Book

S2007

Clinical - Mixed sites, palliation

ESTRO 2024

Keywords: Oligometastatic disease, SABR, bone metastases

References:

[1] Hamaoka T, Costelloe CM, Madewell JE, et al. Tumour response interpretation with new tumour response criteria vs the World Health Organisation criteria in patients with bone-only metastatic breast cancer. Br J Cancer. 2010;102:651-7. https://doi.org/10.1038/sj.bjc.6605546. [2] Cox BW, Spratt DE, Lovelock M, et al. International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 2012;83:e597-605. https://doi.org/10.1016/j.ijrobp.2012.03.009.

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AN HARMONIZATION INSTITUTIONAL PROTOCOL FOR THE MANAGEMENT OF SPINAL METS: A DOSE INTENSITY ANALYSIS

Maria Grazia Carnevale, Mauro Loi, Gabriele Simontacchi, Lorenzetti Victoria, Carlotta Becherini, Emanuela Olmetto, Pietro Garlatti, Icro Meattini, Giulio Francolini, Luca Visani, Monica Mangoni, Vanessa DiCataldo, Pierluigi Bonomo, Erika Scoccimarro, Beatrice Bettazzi, Doruntina Cela, Lorenzo Livi

Azienda Ospedaliero Universitaria Careggi, Università di Firenze, Radiation Oncology, Florence, Italy

Purpose/Objective:

Stereotactic radiotherapy (SRT) has emerged as a promising treatment option for spinal bone metastases, with increasing evidence suggesting its superiority over standard fractionation approaches [1]. SRT allows for highly conformal dose distribution, minimizing damage to surrounding healthy tissues while delivering a high dose to the target area. However, heterogeneous schedules are used in clinical practice, ranging from high-dose intensive (HDI) to more bland regimens that are iso-intensive as conventional palliative radiotherapy (non-dose intensive, NDI). For instance 24 Gy/3 fraction results in an EQD2 (assuming an α/β of 10) of 36, that is equivalent to 30 Gy/10 fractions. Since January 2021, an institutional internal protocol has been implemented to harmonize the use of HDI regimens either for ablative or palliative purposes on patients with spinal bone metastases treated at our center. We hereby report the results of a harmonization institutional protocol in terms of patterns of care and dose prescription compliance.

Material/Methods:

Data from patients treated with SRT to 3 spine segments from January 2021 to December 2022 were collected. According to protocol, HDI regimens were as follows: 27-30 Gy in 3 fractions (EQD2=43-50) for local ablation in oligometastatic patients or 24 Gy in 2 fractions (EQD2=44) for pain palliation irrespective of tumor burden. Dose