SBRT2015

Re-irradiation for spinal metastases

Spine SBRT as re-treatment

Planning

Set-up / imaging

Study

ss-IMRT

Stereotactic Daily MV-CT kV tracking kV tracking Daily MV-CT

Milker-Zabel 2003

Tomotherapy

Mahan 2005 Sahgal 2009

Cyberknife Cyberknife

Choi 2010

Tomotherapy

Sterzing 2010 Damast 2010

IMRT IMRT

Daily portal images or CBCT Daily CT on rails or CBCT

Garg 2011

Cyberknife Cyberknife

kV tracking kV tracking

Mahadevan 2011

Chang 2012

Evidence-based clinical practice: • IMRT treatment planning required

(100% agreement) (100% agreement)

• Daily IGRT required

SBRT for re-irradiation

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