دورية أكاديمية
Assessment of minimum target dose as a predictor of local failure after spine SBRT.
| العنوان: | Assessment of minimum target dose as a predictor of local failure after spine SBRT. |
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| المؤلفون: | Kowalchuk RO; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Mullikin TC; Duke University, Department of Radiation Oncology, Durham, NC 27710, United States., Spears GM; Mayo Clinic, Department of Statistics, Rochester, MN 55905, United States., Johnson-Tesch BA; Mayo Clinic, Department of Radiology, Rochester, MN 55905, United States., Rose PS; Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN 55905, United States., Siontis BL; Mayo Clinic, Department of Medical Oncology, Rochester, MN 55905, United States., Kun Kim D; Mayo Clinic, Department of Radiology, Rochester, MN 55905, United States., Costello BA; Mayo Clinic, Department of Medical Oncology, Rochester, MN 55905, United States., Morris JM; Mayo Clinic, Department of Radiology, Rochester, MN 55905, United States., Gao RW; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Shiraishi S; Mayo Clinic, Department of Medical Physics, Rochester, MN 55905, United States., Lucido JJ; Mayo Clinic, Department of Medical Physics, Rochester, MN 55905, United States., Olivier KR; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Owen D; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Stish BJ; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Waddle MR; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Laack NN; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Park SS; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Brown PD; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States., Merrell KW; Mayo Clinic, Department of Radiation Oncology, Rochester, MN 55905, United States. Electronic address: merrell.kenneth@mayo.edu. |
| المصدر: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Jun; Vol. 195, pp. 110260. Date of Electronic Publication: 2024 Mar 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8407192 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0887 (Electronic) Linking ISSN: 01678140 NLM ISO Abbreviation: Radiother Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Limerick : Elsevier Scientific Publishers Original Publication: Amsterdam : Elsevier Science Publishers, c1983- |
| مواضيع طبية MeSH: | Radiosurgery*/methods , Radiosurgery*/adverse effects , Spinal Neoplasms*/radiotherapy , Spinal Neoplasms*/surgery , Radiotherapy Dosage*, Humans ; Male ; Middle Aged ; Aged ; Female ; Aged, 80 and over ; Adult ; Treatment Failure ; Retrospective Studies ; Tumor Burden |
| مستخلص: | Objectives: Metastasis-directed stereotactic body radiation therapy (SBRT) has demonstrated robust clinical benefits in carefully selected patients, improving local control and even overall survival (OS). We assess a large database to determine clinical and dosimetric predictors of local failure after spine SBRT. Methods: Spine SBRT treatments with imaging follow-up were identified. Patients were treated with a simultaneous integrated boost technique using 1 or 3 fractions, delivering 20-24 Gy in 1 fraction to the gross tumor volume (GTV) and 16 Gy to the low dose volume (or 27-36 Gy and 21-24 Gy for 3 fraction treatments). Exclusions included: lack of imaging follow-up, proton therapy, and benign primary histologies. Results: 522 eligible spine SBRT treatments (68 % single fraction) were identified in 377 unique patients. Patients had a median OS of 43.7 months (95 % confidence interval: 34.3-54.4). The cumulative incidence of local failure was 10.5 % (7.4-13.4) at 1 year and 16.3 % (12.6-19.9) at 2 years. Local control was maximized at 15.3 Gy minimum dose for single-fraction treatment (HR = 0.31, 95 % CI: 0.17 - 0.56, p < 0.0001) and confirmed via multivariable analyses. Cumulative incidence of local failure was 6.1 % (2.6-9.4) vs. 14.2 % (8.3-19.8) at 1 year using this cut-off, with comparable findings for minimum 14 Gy. Additionally, epidural and soft tissue involvement were predictive of local failure (HR = 1.77 and 2.30). Conclusions: Spine SBRT offers favorable local control; however, minimum dose to the GTV has a strong association with local control. Achieving GTV minimum dose of 14-15.3 Gy with single fraction SBRT is recommended whenever possible. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024. Published by Elsevier B.V.) |
| تواريخ الأحداث: | Date Created: 20240328 Date Completed: 20240516 Latest Revision: 20240516 |
| رمز التحديث: | 20240517 |
| DOI: | 10.1016/j.radonc.2024.110260 |
| PMID: | 38548114 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0887 |
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| DOI: | 10.1016/j.radonc.2024.110260 |