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. 2014 Mar-Apr;4(2):e143-e149.
doi: 10.1016/j.prro.2013.05.006. Epub 2013 Jun 29.

Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases

Dawn Owen  1 , Nadia N Laack  1 , Charles S Mayo  1 , Yolanda I Garces  1 , Sean S Park  1 , Heather J Bauer  1 , Kathryn Nelson  1 , Robert W Miller  1 , Paul D Brown  2 , Kenneth R Olivier  3
Affiliations

Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases

Dawn Owen et al. Pract Radiat Oncol. 2014 Mar-Apr.

Abstract

Purpose: Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases.

Methods and materials: Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity <90 days) and late toxicity (defined as toxicity ≥90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria.

Results: The median age of patients treated was 60 years. The most common histology was prostate cancer (31%) and most patients had fewer than 3 sites of disease at the time of simulation (64%). Most of the non-spine bony sites lay within the pelvis (65%). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8% at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 1-2 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities.

Conclusions: Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Axial slice of stereotactic body radiation therapy (SBRT) bone plan. Red corresponds to the 24 Gy line and blue corresponds to the 18 Gy line. SBRT plan of the left ischium.
See this image and copyright information in PMC

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