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01-05-2021 | Metastasis | Review Article

Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation

Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Authors: Antonio Pontoriero, Sara Lillo, Luciana Caravatta, Fabiana Bellafiore, Silvia Longo, Elisabetta Lattanzi, Silvana Parisi, Francesco Fiorica, Mariangela Massaccesi

Published in: Strahlentherapie und Onkologie | Issue 5/2021

Abstract

Purpose

The aim of this study was to identify patient-, tumor-, or treatment-related factors which may affect disease-related outcomes of re-irradiation (reRT) in patients with previously irradiated vertebral metastases.

Methods

A computerized search of the literature was performed by searching for terms related to reRT and spinal metastases in MEDLINE, EMBASE, OVID, and the Cochrane database from 1995 to 2019. Studies including at least 10 patients who had received reRT at the same site of initial radiotherapy for vertebral metastases with localized external beam radiotherapy were included. To determine the pooled ≥G3 acute and late toxicity rate, pain relief, local control, and overall survival, a meta-analysis technique of single-arm studies was performed.

Results

Nineteen studies including 1373 patients met the inclusion criteria for this systematic review. The pooled pain relief, neurological improvement, 1‑year local control, and 1‑year overall survival rates were 74.3%, 73.8%, 78.8%, and 54.6%, respectively, with moderate to high heterogeneity among studies. No difference in heterogeneity was evidenced for pain relief or local control after omitting studies not using stereotactic body radiotherapy (SBRT) or studies delivering biologically effective dose (BED) < 45 Gy₁₀, whereas heterogeneity for 1‑year OS was lower after omitting studies not using SBRT and delivering BED < 45 Gy₁₀. The pooled results of grade ≥ 3 acute and late toxicity were 0.4% (95% confidence interval: 0.1–1.2%) and 2.2% (95% confidence interval: 1.2–37%), respectively, with low heterogeneity among studies.

Conclusion

While this systematic review confirmed that reRT is both safe and effective for treating patients with recurrent spinal metastases, it could not identify factors which may affect outcomes of reRT in this patient population.

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Title: Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation
Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)
Authors: Antonio Pontoriero
Sara Lillo
Luciana Caravatta
Fabiana Bellafiore
Silvia Longo
Elisabetta Lattanzi
Silvana Parisi
Francesco Fiorica
Mariangela Massaccesi
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 5/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01748-7

Keynote webinar | Spotlight on sleep in brain health

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Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation

Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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