Image-guided robotic radiosurgery for spinal metastases

Radiother Oncol. 2007 Feb;82(2):185-90. doi: 10.1016/j.radonc.2006.11.023. Epub 2007 Jan 24.

Abstract

Background and purpose: To determine the effectiveness and safety of image-guided robotic radiosurgery for spinal metastases.

Materials/methods: From 1996 to 2005, 74 patients with 102 spinal metastases were treated using the CyberKnife at Stanford University. Sixty-two (84%) patients were symptomatic. Seventy-four percent (50/68) of previously treated patients had prior radiation. Using the CyberKnife, 16-25 Gy in 1-5 fractions was delivered. Patients were followed clinically and radiographically for at least 3 months or until death.

Results: With mean follow-up of 9 months (range 0-33 months), 36 patients were alive and 38 were dead at last follow-up. No death was treatment related. Eighty-four (84%) percent of symptomatic patients experienced improvement or resolution of symptoms after treatment. Three patients developed treatment-related spinal injury. Analysis of dose-volume parameters and clinical parameters failed to identify predictors of spinal cord injury.

Conclusions: Robotic radiosurgery is effective and generally safe for spinal metastases even in previously irradiated patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Palliative Care
  • Prospective Studies
  • Radiosurgery / methods*
  • Robotics*
  • Spinal Neoplasms / secondary*
  • Spinal Neoplasms / surgery*
  • Surgery, Computer-Assisted*
  • Treatment Outcome