State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Med Oncol. 2022 May 23;39(5):103. doi: 10.1007/s12032-021-01613-8.
To evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) in treating spinal metastases. Two reviewers performed independent literature searches of the PubMed database, searching literatures of the efficacy and safety of SBRT in metastatic spinal diseases. A total of 67 studies were included in the review. Regarding SBRT for de novo spinal metastases, the 1- and 2-year local control (LC) rates were 51-100% and 56-96%, respectively. The local failure rate was 10.5-47.5%, with most studies reporting a local failure rate of < 30%. The 1- and 2-year overall survival (OS) rates were 25.7-80% and 25-60.7%, respectively. The pain relief rate was 41.6-100%. In the postoperative scenario, the LC rate was 70-100%, and the local failure rate was 11.7-33%. Regarding the reirradiated setting, the 1-year LC rate was 71-83%, the local failure rate was 6.0-25.5%, and the 1-year OS rate was 28-68%. The pain relief rate was approximately 35.7-77%. Between studies on single- and multi-fraction SBRT, the 1- and 2-year LC rates with single-fraction SBRT were 71-95% and 70-96%, respectively; the 1- and 2-year OS rates with single-fraction SBRT were 43.5-46% and 43.5-49%, respectively. For the management of spinal metastases, it appears that regardless of the clinical scenario in which SBRT is applied, a high rate of LC is achieved, particularly with single-fraction SBRT, regardless of histology. Additionally, spinal SBRT can establish durable pain palliation with acceptable toxicities.
评估立体定向体放射治疗（SBRT）治疗脊柱转移瘤的疗效和安全性。两位审查员对 PubMed 数据库进行了独立的文献检索，检索了 SBRT 治疗转移性脊柱疾病的疗效和安全性的文献。共有 67 项研究纳入综述。对于新诊断的脊柱转移瘤的 SBRT，1 年和 2 年局部控制（LC）率分别为 51-100%和 56-96%。局部失败率为 10.5-47.5%，大多数研究报告局部失败率<30%。1 年和 2 年总生存率（OS）率分别为 25.7-80%和 25-60.7%。疼痛缓解率为 41.6-100%。在术后情况下，LC 率为 70-100%，局部失败率为 11.7-33%。在再照射的情况下，1 年 LC 率为 71-83%，局部失败率为 6.0-25.5%，1 年 OS 率为 28-68%。疼痛缓解率约为 35.7-77%。在单次和多次分割 SBRT 的研究之间，单次分割 SBRT 的 1 年和 2 年 LC 率分别为 71-95%和 70-96%；1 年和 2 年 OS 率分别为 43.5-46%和 43.5-49%。对于脊柱转移瘤的治疗，似乎无论 SBRT 应用于哪种临床情况，LC 率都很高，特别是单次分割 SBRT，与组织学无关。此外，脊柱 SBRT 可以在可接受的毒性作用下建立持久的疼痛缓解。
