SBRT2015

Re-irradiation for spinal metastases

Spine SBRT as re-treatment

Follow-up (months)

Myelopathy

Lcoal / pain control

# patients / cases

Study

12.3 15.2

0% 0% 0%

95%

Milker-Zabel 2003

18 / 19

100%

Mahan 2005 Sahgal 2009

8 / 8

7 7

70% 73% 63% 66% 76% 93%

25 / 37 42 / 51 36 / 36 94 / 97 59 / 63

n=1 G4

Choi 2010

7.5

0% 0%

Sterzing 2010 Damast 2010

12.1

13 12

n=2 G3 peripheral nerve injury n=3 persistent radicular pain n=1 lower-extremity weakness

Garg 2011

Mahadevan 2011

60 / 81

17.3

0%

79%

Chang 2012

49 / 54

Evidence-based clinical practice: • Very low incidence of myelopathy • Nerve damage a more frequent toxicity • Promising local control 63 – 100%

SBRT for re-irradiation

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