Assessment of the Outcome of Treating Spinal Oligometastases with Stereotactic Ablative Body Radiotherapy


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Helen Saxby1,Veni Ezhil2
1Charing Cross Hospital,2Royal Surrey County Hospital

Abstract

Background

Spinal metastases are common in patients with advanced cancer and can cause severe morbidity. Stereotactic ablative body radiotherapy (SABR) has been shown to be a safe and effective treatment of spinal metastases with a 90% local control rate [1].

The aim of this study was to assess the outcome of patients who had received SABR to spinal oligometastases at the Royal Surrey County Hospital (RSCH) under the Commissioning through Evaluation programme.

Method

Data were collected retrospectively from the institutional SABR database. All patients who received SABR to spinal oligometastases at the RSCH between 01.01.2016 and 01.01.2019 were included. Patients were treated using a TrueBeam linear accelerator.

Results

24 spinal metastases were treated in 18 patients. 12 patients had a single spinal metastasis treated and 6 patients had two spinal metastases treated. The median age of patients was 69 years (range 45 to 79 years).

Of the patients treated nine (50.0%) had a primary prostate cancer, four (22.2%) had a primary breast cancer, three (16.7%) had a primary renal cancer, one (5.6%) had a primary lung cancer and one (5.6%) had a primary thyroid cancer. Of the 24 spinal metastases treated 3 (12.5%) were cervical, 13 (54.2%) thoracic and 8 (33.3%) lumbar.

The median length of follow up was 1.5 years (range 6 months to 3.5 years). All patients are currently alive and none experienced grade three or four toxicity following treatment. There was a 100% local control rate of the spinal metastases. Seven patients (38.9%) experienced distant relapse of their disease.

Conclusion

This study has shown SABR to be a safe and effective treatment for spinal oligometastases. There was an excellent (100%) local control rate of spinal oligometastases from multiple primary tumour sites using SABR.