a Department of Radiation Oncology , National University Cancer Institute Singapore, National University Health System , Singapore.
b Department of Radiation Oncology , Cleveland Clinic , Cleveland , OH , USA.
Expert Rev Anticancer Ther. 2018 Sep;18(9):887-900. doi: 10.1080/14737140.2018.1493381. Epub 2018 Jul 3.
Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This leads to improved efficacy, shortened treatment schedule, and potentially reduced treatment-related toxicity. Areas covered: In this review, we will look at the progress made by stereotactic body radiotherapy (SBRT) in the management of SM. We will review the technological factors which have enabled the widespread use of SBRT. The efficacy of SBRT, in various clinical scenarios, and associated toxicities will be reviewed. Lastly, we will discuss about patient selection and provide a five-year roadmap. Expert commentary: Spine SBRT is a safe and efficacious treatment option. Practice guidelines recommend the use of SBRT in oligometastatic patients especially those with radio-resistant cancer types, and in scenarios involving re-irradiation. SBRT offers patients dose-intensification over a short schedule which may allow less time off systemic therapy. The results of the phase III trials are eagerly awaited.
由于临床治疗和系统治疗的进步，越来越多的患者被诊断出患有脊柱转移瘤（SM），并能活得更久。与此同时，放射肿瘤学领域也取得了巨大的技术进步。软件和硬件的进步都能够将三维（和四维）身体成像与空间精确的治疗方法结合起来。这提高了疗效，缩短了治疗时间表，并可能降低了与治疗相关的毒性。涵盖领域：在这篇综述中，我们将探讨立体定向体放射治疗（SBRT）在 SM 治疗中的进展。我们将回顾使 SBRT 广泛应用的技术因素。将回顾 SBRT 在各种临床情况下的疗效和相关毒性。最后，我们将讨论患者选择并提供五年路线图。专家评论：脊柱 SBRT 是一种安全有效的治疗选择。实践指南建议在寡转移患者中使用 SBRT，特别是那些具有放射抗性癌症类型的患者，以及在需要再照射的情况下。SBRT 在短时间内提供了更高的剂量强度，这可能会减少患者停止全身治疗的时间。人们急切地等待着 III 期试验的结果。
