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  • Guninski, R. S.University Hospital of Zurich (författare)

Efficacy and safety of SBRT for spine metastases : A systematic review and meta-analysis for preparation of an ESTRO practice guideline

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • 2023

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:451c5cba-92dc-4814-aa79-4cbb6db152ed
  • https://lup.lub.lu.se/record/451c5cba-92dc-4814-aa79-4cbb6db152edURI
  • https://doi.org/10.1016/j.radonc.2023.109969DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • Background and purpose: Advances in characterizing cancer biology and the growing availability of novel targeted agents and immune therapeutics have significantly changed the prognosis of many patients with metastatic disease. Palliative radiotherapy needs to adapt to these developments. In this study, we summarize the available evidence for stereotactic body radiotherapy (SBRT) in the treatment of spinal metastases. Materials and methods: A systematic review and meta-analysis was performed using PRISMA methodology, including publications from January 2005 to September 2021, with the exception of the randomized phase III trial RTOG-0631 which was added in April 2023. Re-irradiation was excluded. For meta-analysis, a random-effects model was used to pool the data. Heterogeneity was assessed with the I2-test, assuming substantial and considerable as I2 > 50 % and I2 > 75 %, respectively. A p-value < 0.05 was considered statistically significant. Results: A total of 69 studies assessing the outcomes of 7236 metastases in 5736 patients were analyzed. SBRT for spine metastases showed high efficacy, with a pooled overall pain response rate of 83 % (95 % confidence interval [CI] 68 %-94 %), pooled complete pain response of 36 % (95 % CI: 20 %-53 %), and 1-year local control rate of 94 % (95 % CI: 86 %-99 %), although with high levels of heterogeneity among studies (I2 = 93 %, I2 = 86 %, and 86 %, respectively). Furthermore, SBRT was safe, with a pooled vertebral fracture rate of 9 % (95 % CI: 4 %-16 %), pooled radiation induced myelopathy rate of 0 % (95 % CI 0–2 %), and pooled pain flare rate of 6 % (95 % CI: 3 %-17 %), although with mixed levels of heterogeneity among the studies (I2 = 92 %, I2 = 0 %, and 95 %, respectively). Only 1.7 % of vertebral fractures required surgical stabilization. Conclusion: Spine SBRT is characterized by a favorable efficacy and safety profile, providing durable results for pain control and disease control, which is particularly relevant for oligometastatic patients.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Cuccia, F.ARNAS Civico Hospital (författare)
  • Alongi, F.University of Brescia (författare)
  • Andratschke, N.University Hospital of Zurich (författare)
  • Belka, C.University Hospital Munich (författare)
  • Bellut, D.University Hospital of Zurich (författare)
  • Dahele, M.Vrije Universiteit Amsterdam (författare)
  • Josipovic, M.University of Copenhagen,Copenhagen University Hospital (författare)
  • Kroese, T. E.University Hospital of Zurich (författare)
  • Mancosu, P.Humanitas Research Hospital (författare)
  • Minniti, G.Istituto Neurologico Mediterraneo Neuromed (författare)
  • Niyazi, M.University Hospital of Tubingen (författare)
  • Ricardi, U.University of Turin (författare)
  • Munck af Rosenschold, P.Lund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Radiotherapy Physics,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,LTH profilområde: Avancerade ljuskällor,LTH profilområden,Lunds Tekniska Högskola,LU profilområde: Ljus och material,Lunds universitets profilområden,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,LTH Profile Area: Photon Science and Technology,LTH Profile areas,Faculty of Engineering, LTH,LU Profile Area: Light and Materials,Lund University Profile areas,Skåne University Hospital(Swepub:lu)pe1188mu (författare)
  • Sahgal, A.Odette Cancer Centre (författare)
  • Tsang, Y.Princess Margaret Hospital University of Toronto (författare)
  • Verbakel, W. F.A.R.Academic Medical Center of University of Amsterdam (AMC) (författare)
  • Guckenberger, M.University Hospital of Zurich (författare)
  • University Hospital of ZurichARNAS Civico Hospital (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Radiotherapy and Oncology0167-8140

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