Radiosurgery Society Case-Based Guide to Stereotactic Body Radiation Therapy for Challenging Cases of Spinal Metastases.

IF 3.4 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2024-09-03 DOI:10.1016/j.prro.2024.08.004

Khaled Aziz, Daniel Koffler, April Vassantachart, Abbas Rattani, Nii-Kwanchie Ankrah, Emile Gogineni, Therese Y Andraos, Arjun Sahgal, Balamurugan Vellayappan, Emma M Dunne, Shankar Siva, Fabio Y Moraes, Matthias Guckenberger, Daniel Lubelski, Samuel Chao, Stephanie Combs, Eric Chang, Anubhav G Amin, Matthew Foote, Iris Gibbs, Minsun Kim, Joshua Palmer, Simon Lo, Kristin J Redmond

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引用次数: 0

Abstract

Purpose: Spinal stereotactic body radiation therapy (SBRT) has become the standard of care in management of patients with limited sites of metastatic disease, radioresistant histologies, painful vertebral metastases with long life expectancy and cases of reirradiation. Our case-based guidelines aim to assist radiation oncologists in the appropriate utilization of SBRT for common, yet challenging, cases of spinal metastases.

Methods and materials: Cases were selected to include scenarios of large volume sacral disease with nerve entrapment, medically inoperable disease abutting the thecal sac, and local failure after prior SBRT. Relevant literature was reviewed, and areas requiring further investigation were discussed to offer a framework for evidence-based clinical practice.

Results: Spinal SBRT can be effectively delivered in challenging cases following multidisciplinary discussion by using a methodical approach to patient selection, appropriate dose selection, and adherence to evidence-based dose constraints.

Conclusions: The Radiosurgery Society's case-based practice review offers guidance to practicing physicians treating technically challenging SBRT candidate patients with spinal metastases.

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放射外科协会《针对脊柱转移瘤疑难病例的立体定向体放射治疗病例指南》。

目的：脊柱立体定向体放射治疗（SBRT）已成为治疗转移性疾病部位有限、放射抗性组织学、预期寿命长的疼痛性椎体转移以及再照射病例的标准治疗方法。我们基于病例的指南旨在帮助放射肿瘤专家在常见但具有挑战性的脊柱转移病例中适当使用 SBRT：我们选择的病例包括神经卡压的大体积骶骨疾病、与椎管囊相邻的医学上无法手术的疾病以及之前SBRT治疗局部失败的病例。对相关文献进行了回顾，并讨论了需要进一步研究的领域，为循证临床实践提供了一个框架：结果：经过多学科讨论，脊柱SBRT可以在具有挑战性的病例中有效实施，方法是有条不紊地选择患者、选择合适的剂量并遵守循证剂量限制：放射外科协会基于病例的实践评论为执业医师治疗具有技术难度的脊柱转移瘤 SBRT 候选患者提供了指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.