ESTRO 2025 - Abstract Book

S1577

Clinical – Mixed sites & palliation

ESTRO 2025

[3] E. Chow, L. Zeng, N. Salvo, K. Dennis, M. Tsao, S. Lutz, Clin Oncol (R Coll Radiol) 2012, 24, 112-124 [4] J. M. van der Velden, H. M. Verkooijen, E. Seravalli, J. Hes, A. S. Gerlich, N. Kasperts, W. S. C. Eppinga, J.-J. Verlaan, M. van Vulpen, BMC cancer 2016, 16, 909-909.

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Digital Poster Comparison of Vertebral Fracture Incidence and Pain Dynamics in EBRT vs. SBRT for Vertebral Metastases: A Retrospective Analysis Leonie von Brunn, Mateo Jukic, Marco ME Vogel, Kerstin A Eitz, Stephanie E Combs Radiationoncology, Klinikum Rechts der Isar TUM, Munich, Germany Purpose/Objective: Vertebral body metastases are common in oncology patients. 1 Treatment options include conventional external beam radiotherapy (EBRT) and stereotactic body radiotherapy (SBRT). Due to the higher biological dose, SBRT is expected to achieve better oncologic control. 2 However, there is also an increased observation of unwanted vertebral compression fractures (VCFs) following SBRT. 3 Material/Methods: In this retrospective analysis, EBRT and SBRT for vertebral body metastases were compared regarding pain dynamics post-radiotherapy (RT) and the incidence of VCF. Inclusion criteria encompassed patients with vertebral body metastases treated between 2000 and 2021. Re-irradiations and treatment interruptions were excluded. Results: A total of 843 patients (287 female; 556 male) with 1215 RTs of vertebral body metastases were included, comprising 97 SBRTs and 1118 EBRTs. The median age of patients was 67 years (range: 18 – 92 years), with prostate, breast, and lung cancer being the most common tumor types. In 372 RTs, a VCF was already present before irradiation. After RT, 6 VCFs (6.1% of SBRTs%) occurred in the radiation field following SBRT and 60 VCFs (5.4 of EBRTs%) following EBRT. Pain dynamics within the first six months (after six months) post-RT for SBRT were as follows: 60.0% (34.0%) reported no change in pain, 11.3% (7.2%) experienced pain reduction, and 9.2% (24.7%) reported worsening pain. In 19.6% (34.0%) of cases, no information on pain dynamics could be obtained. For EBRT, pain dynamics showed that 27.7% (14.3%) reported no change in pain, 22.1% (10.7%) experienced pain reduction, and 9.0% (10.5%) reported worsening pain. In 41.1% (64.5%) of cases, no data on pain development were available. Conclusion: In our cohort, a comparable incidence of VCFs was observed. Within the first six months post-RT, EBRT showed a higher proportion of pain reduction, whereas SBRT showed a higher proportion of pain stability throughout the entire follow-up period.

Keywords: SBRT, vertebral metastasis

References: (1) Coleman, R. E. Clinical Cancer Research 2006 , 12 (20), 6243s. (2) van der Velden, J. M.; Verkooijen, H. M.; Seravalli, E.; Hes, J.; Gerlich, A. S.; Kasperts, N.; Eppinga, W. S. C.; Verlaan, J.-J.; van Vulpen, M. BMC cancer 2016 , 16 (1), 909-909. (3) Faruqi, S.; Tseng, C. L.; Whyne, C.; Alghamdi, M.; Wilson, J.; Myrehaug, S.; Soliman, H.; Lee, Y.; Maralani, P.; Yang, V.; et al. Neurosurgery 2018 , 83 (3), 314-322.