Vertebral Body Collapse After Spine Stereotactic Body Radiation Therapy: A Single-Center Institutional Experience

Authors

  • Arsh Issany Roswell Park Comprehensive Cancer Center
  • Austin J. Iovoli Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.
  • Richard Wang Kirk Kerkorian School of Medicine, University of Nevada, 625 Shadow Ln, Las Vegas, NV 89106. USA.
  • Rohil Shekher Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.
  • Sung Jun Ma Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.
  • Victor Goulenko Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.
  • Fatemeh Fekrmandi Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.
  • Dheerendra Prasad Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets Buffalo, NY 14203. USA.

Abstract

Background: Spine stereotactic body radiation therapy (SBRT) for the treatment of metastatic disease is increasingly utilized owing to improved pain and local control over conventional regimens. Vertebral body collapse (VBC) is an important toxicity following spine SBRT. We investigated our institutional experience with spine SBRT as it relates to VBC and spinal instability neoplastic score (SINS).

Patients and Methods: Records of 83 patients with 100 spinal lesions treated with SBRT between 2007 and 2022 were reviewed. Clinical information was abstracted from the medical record. The primary endpoint was post-treatment VBC. Logistic univariate analysis was performed to identify clinical factors associated with VBC.

Results: Median dose and number of fractions used was 24 Gy and 3 fractions, respectively. There were 10 spine segments that developed VBC (10%) after spine SBRT. Median time to VBC was 2.4 months. Of the 11 spine segments that underwent kyphoplasty prior to SBRT, none developed subsequent VBC. No factors were associated with VBC on univariate analysis.

Conclusion: The rate of vertebral body collapse following spine SBRT is low. Prophylactic kyphoplasty may provide protection against VBC and should be considered for patients at high risk for fracture.

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Published

2024-09-09

How to Cite

Issany, A., Iovoli, A. J., Wang, R., Shekher, R., Ma, S. J., Goulenko, V., … Prasad, D. (2024). Vertebral Body Collapse After Spine Stereotactic Body Radiation Therapy: A Single-Center Institutional Experience. Radiology and Oncology, 58(3), 425–431. Retrieved from https://radioloncol.com/index.php/ro/article/view/4284

Issue

Section

Clinical oncology