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Dose-intensified SBRT for vertebral oligometastases: results from a prospective clinical trial

Purpose - To prospectively evaluate safety and efficacy of dose-intensified multifraction SBRT using a simultaneous-integrated boost concept for vertebral oligometastases. - Material and Methods - Data from 128 patients with 143 vertebral oligometastases (≤5 distant metastases in total) treated with...

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Main Authors: Guckenberger, Matthias (Author) , Wilke, Lotte (Author) , Billiet, Charlotte (Author) , Rogers, Susanne (Author) , Franzese, Ciro (Author) , Schnell, Daniel (Author) , Spałek, Mateusz (Author) , Aebersold, Daniel M. (Author) , Hemmatazad, Hossein (Author) , Zilli, Thomas (Author) , Boda-Heggemann, Judit (Author) , Baumert, Brigitta (Author) , Stelmes, Jean-Jacques (Author) , Nägler, Franziska (Author) , Gut, Philipp (Author) , Weiß, Christian (Author) , Bruni, Alessio (Author) , Zimmermann, Frank (Author) , Förster, Robert (Author) , Zimmer, Jörg (Author) , Madani, Indira (Author)
Format: Article (Journal)
Language:English
Published: July 2025
In: Radiotherapy and oncology
Year: 2025, Volume: 208, Pages: 1-7
ISSN:1879-0887
DOI:10.1016/j.radonc.2025.110940
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.radonc.2025.110940
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S016781402500235X
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Author Notes:Matthias Guckenberger, Lotte Wilke, Charlotte Billiet, Susanne Rogers, Ciro Franzese, Daniel Schnell, Mateusz Spałek, Daniel M. Aebersold, Hossein Hemmatazad, Thomas Zilli, Judit Boda-Heggemann, Brigitta G. Baumert, Jean-Jacques Stelmes, Franziska Nägler, Philipp Gut, Christian Weiß, Alessio Bruni, Frank Zimmermann, Robert Förster, Jörg Zimmer, Indira Madani
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Summary:Purpose - To prospectively evaluate safety and efficacy of dose-intensified multifraction SBRT using a simultaneous-integrated boost concept for vertebral oligometastases. - Material and Methods - Data from 128 patients with 143 vertebral oligometastases (≤5 distant metastases in total) treated with dose-intensified SBRT (48.5 Gy/10 [with epidural involvement] or 40 Gy/5 [without epidural involvement]) in the randomized and non-randomized arms of a phase 3 clinical trial conducted at 18 international centers between 2016 and 2023 were analyzed. - Results - The median age of all patients was 68 years; 77 patients (60.2%) had breast and prostate cancer. Of 143 vertebral metastases, 23 (16.1%) and 22 metastases (15.4%) had epidural and paraspinal tumor involvement, respectively. The median follow-up time was 24 months. At 2 years, cumulative incidence of local failure (4 failures) was 5.3%. There were 4 (2.8%) baseline and 8 (5.6%) de novo vertebral compression fractures (VCFs). Two-year OS was 82.2% (95% CI, 74.9-89.6%). There was no grade ≥ 4 adverse events (AE) and the crude rate of grade 3 AEs was 5.5%; no myelopathy or plexopathy was observed. On multivariate analysis, only non-breast or non-prostate cancer (HR, 7.91; 95%, CI 1.79-35.03; 2-sided P = 0.01) were found to be prognostic for adverse OS. No prognostic factors for VCF were identified. Epidural and paraspinal involvement were not found to be prognostic for treatment outcome. - Conclusions - Dose-intensified SBRT for vertebral oligometastases is effective and safe, even in high-risk patients with epidural or paraspinal involvement.
Item Description:Online verfügbar: 14. Mai 2025, Artikelversion: 24. Mai 2025
Gesehen am 04.09.2025
Physical Description:Online Resource
ISSN:1879-0887
DOI:10.1016/j.radonc.2025.110940

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