Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1185-92. doi: 10.1016/j.ijrobp.2009.03.062. Epub 2009 Jul 23.
To evaluate the outcomes associated with stereotactic body radiotherapy (SBRT) in the management of spinal metastases from renal cell carcinoma (RCC).
SBRT was used in the treatment of patients with spinal metastases from RCC. Patients received either 24 Gy in a single fraction, 27 Gy in three fractions, or 30 Gy delivered in five fractions. Effectiveness of SBRT with respect to tumor control and palliation of pain was assessed using patient-reported outcomes.
A total of 48 patients with 55 spinal metastases were treated with SBRT with a median follow-up time of 13.1 months (range, 3.3-54.5 months). The actuarial 1-year spine tumor progression free survival was 82.1%. At pretreatment baseline, 23% patients were pain free; at 1 month and 12 months post-SBRT, 44% and 52% patients were pain free, respectively. No Grade 3-4 neurologic toxicity was observed.
The data support SBRT as a safe and effective treatment modality that can be used to achieve good tumor control and palliation of pain associated with RCC spinal metastases. Further evaluation with randomized trials comparing SBRT to conventional radiotherapy may be warranted.
评估立体定向体放射治疗（SBRT）在治疗肾细胞癌（RCC）脊柱转移中的疗效。
对 RCC 脊柱转移患者采用 SBRT 治疗。患者接受单次 24 Gy、3 次 27 Gy 或 5 次 30 Gy 的分割剂量照射。采用患者报告的结局来评估 SBRT 对肿瘤控制和缓解疼痛的效果。
共对 48 例 55 处脊柱转移灶进行了 SBRT 治疗，中位随访时间为 13.1 个月（范围：3.3-54.5 个月）。1 年脊柱肿瘤无进展生存率的估计值为 82.1%。在治疗前基线时，23%的患者无疼痛；在 SBRT 后 1 个月和 12 个月时，分别有 44%和 52%的患者无疼痛。未观察到 3-4 级神经毒性。
这些数据支持 SBRT 是一种安全有效的治疗方法，可用于实现良好的肿瘤控制和缓解 RCC 脊柱转移相关疼痛。可能需要进一步进行与常规放疗比较的随机试验来进行评估。
