Primary Stereotactic Body Radiation Therapy for Breast Cancer Spinal Metastases.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-03-04 DOI:10.1016/j.clbc.2025.03.001

Kuan-Nien Chou, David J Park, Yusuke S Hori, Sara C Emrich, Louisa Ustrzynski, Armine Tayag, Cynthia Chuang, Erqi Pollom, Cheng-Hsiang Lo, Steven D Chang

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引用次数: 0

Abstract

Background: To present insights gained from a decade of employing stereotactic body radiation therapy (SBRT) as a primary intervention for spinal bone metastasis (SBM) originating from breast cancer (BC).

Methods: We retrospectively examined the application of primary SBRT (the CyberKnife System) for BC SBMs between March 2012 and January 2023.

Results: We recruited 47 female patients with 82 SBMs affecting 104 vertebrae. The mean age was 53.2 ± 12.7 years. The overall local control (LC) rate of primary SBRT for BC SBMs was 84.1%. The median local progression (LP) occurred at 12 (3-66) months. The LP rates were 9.7%, 13.3%, and 18.3% at 1, 3, and 5 years following SBRT. We observed a lower LC rate in White patients than that in Asian patients. Factors associated with an increased risk of LP included SBMs from invasive lobular carcinoma, and patients with lower revised Tokuhashi scores. Additionally, the 1-, 3-, and 5-year LP rates of different SFED (≥20 Gy vs. <20 Gy) were 4.3% versus 19.1%, 7.2% versus 24.0%, and 11.5% versus 28.9%. The incidence of acute local adverse events (AEs) was 24.4% and was significantly associated with advanced age and prescribed target coverage of less than 95%.

Conclusions: We have demonstrated SBRT using the CyberKnife System as an effective primary intervention for BC SBMs. Our findings underscore the importance of treatment planning to optimize outcomes and minimize AEs in patients undergoing SBRT for SBMs.

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原发性立体定向放射治疗乳腺癌脊柱转移。

背景：介绍近十年来立体定向全身放射治疗（SBRT）作为原发性乳腺癌（BC）脊柱骨转移（SBM）的主要干预手段的见解。方法：我们回顾性研究了2012年3月至2023年1月间初级SBRT（射波刀系统）在BC型SBMs中的应用。结果：我们招募了47例女性患者，共82例SBMs，影响104根椎骨。平均年龄53.2±12.7岁。原发性SBRT对BC型SBMs的总体局部控制率（LC）为84.1%。中位局部进展（LP）发生在12（3-66）个月。SBRT后1年、3年和5年的LP率分别为9.7%、13.3%和18.3%。我们观察到白人患者的LC率低于亚洲患者。与LP风险增加相关的因素包括侵袭性小叶癌引起的SBMs，以及修订后的Tokuhashi评分较低的患者。此外，不同SFED的1、3和5年LP率（≥20 Gy）与结论：我们已经证明使用射波刀系统的SBRT是治疗BC型SBMs的有效主要干预措施。我们的研究结果强调了治疗计划对于优化SBMs患者接受SBRT治疗的结果和最小化不良事件的重要性。

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

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.