Document Detail


Clinical results of retreatment of vertebral bone metastases by stereotactic conformal radiotherapy and intensity-modulated radiotherapy.
MedLine Citation:
PMID:  12504049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Reirradiation of spinal tumors is limited by the tolerance of the spinal cord. We evaluated local control, pain relief, neurologic improvement, side effects, and survival rates after fractionated conformal radiotherapy (FCRT) and intensity-modulated RT (IMRT) of recurrent spinal metastases. METHODS AND MATERIALS: Eighteen patients with 19 radiologic manifestations were retreated for recurrent spinal metastases using FCRT (n = 5) or IMRT (n = 14). All patients had previously undergone conventional RT (median dose 38 Gy). The indication for reirradiation was tumor progression associated with pain (n = 16) or neurologic symptoms (n = 12). The median time to recurrence was 17.7 months. The median total dose for reirradiation was 39.6 Gy. RESULTS: The overall local control rate was 94.7% after a median follow-up of 12.3 months. Of 16 patients with pain, 13 experienced significant relief after reirradiation. Neurologic improvement was obtained in 5 of 12 patients. Tumor size remained unchanged in 84.2%. A partial response was seen in 2 of 19 patients. One patient had local tumor progression 9.5 months after reirradiation. Six patients received chemotherapy after reirradiation because of progressive distant metastases. Twelve patients died 10.5 months median after reirradiation. No clinically significant late toxicity was seen after FCRT or IMRT. CONCLUSION: These data demonstrate that FCRT and IMRT are effective and safe in recurrent spinal tumors and can be offered to patients to achieve local control, as well as pain relief.
Authors:
Stefanie Milker-Zabel; Angelika Zabel; Christoph Thilmann; Wolfgang Schlegel; Michael Wannenmacher; Jürgen Debus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  55     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2002-12-30     Completed Date:  2003-01-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  162-7     Citation Subset:  IM    
Affiliation:
Department of Clinical Radiology, Radiation Therapy, University of Heidelberg, Heidelberg, Germany. Stefanie_Milker-Zabel@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Male
Radiotherapy Dosage
Radiotherapy, Conformal / methods*
Retreatment
Spinal Neoplasms / mortality,  radiotherapy*,  secondary*
Stereotaxic Techniques
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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