(1) Purpose: To assess the safety and effectivity of stereotactic body radiotherapy (SBRT) on spinal metastases utilizing a simultaneous integrated boost (SIB) concept in oligometastatic cancer patients. (2) Methods: 62 consecutive patients with 71 spinal metastases received SIB–SBRT between 01/2013 and 09/2022 at our institution. We retrospectively analyzed toxicity, local tumor control (LC), and progression-free (PFS) and overall survival (OS) following SIB–SBRT and assessed possible influencing factors (Kaplan–Meier estimator, log-rank test and Cox proportional-hazards model). (3) Results: SIB–SBRT was delivered in five fractions, mostly with 25/40 Gy (n= 43; 60.56%) and 25/35 Gy (n= 19, 26.76%). Estimated rates of freedom from VCF were 96.1/90.4% at one/two years. VCF development was significantly associated with osteoporosis (p< 0.001). No ≥ grade III acute and one grade III late toxicity (VCF) were observed. Estimated LC rates at one/two years were 98.6/96.4%, and histology was significantly associated with local treatment failure (p= 0.039). Median PFS/OS was 10 months (95% CI 6.01–13.99)/not reached. Development of metastases ≥ one year after initial diagnosis and Karnofsky Performance Score ≥ 90% were predictors for superior PFS (p= 0.038) and OS (p= 0.012), respectively. (4) Conclusion: Spinal SIB–SBRT yields low toxicity and excellent LC. It may be utilized in selected oligometastatic patients to improve prognosis. To the best of our knowledge, we provide the first clinical data on the toxicity and effectivity of SIB–SBRT in spinal metastases in a larger patient cohort.
(1) 目的：评估立体定向放射治疗（SBRT）采用同步整合推量（SIB）技术治疗寡转移癌症患者脊柱转移瘤的安全性和有效性。(2) 方法：2013年1月至2022年9月期间，本机构连续对62例患者的71处脊柱转移灶实施了SIB-SBRT。我们回顾性分析了SIB-SBRT后的毒性反应、局部肿瘤控制率（LC）、无进展生存期（PFS）和总生存期（OS），并评估了可能的影响因素（采用Kaplan-Meier估计量、对数秩检验和Cox比例风险模型）。(3) 结果：SIB-SBRT治疗分5次进行，主要剂量方案为25/40 Gy（n=43；60.56%）和25/35 Gy（n=19；26.76%）。预计1年/2年无椎体压缩性骨折（VCF）发生率分别为96.1%/90.4%。VCF的发生与骨质疏松显著相关（p<0.001）。未观察到≥III级的急性毒性反应，仅出现1例III级晚期毒性反应（VCF）。预计1年/2年局部控制率分别为98.6%/96.4%，组织学类型与局部治疗失败显著相关（p=0.039）。中位PFS为10个月（95% CI 6.01–13.99），中位OS未达到。初次诊断后≥1年出现转移和卡氏功能状态评分≥90%分别是PFS（p=0.038）和OS（p=0.012）更优的预测因素。(4) 结论：脊柱SIB-SBRT治疗毒性反应低且局部控制率优异。该技术可用于经过选择的寡转移患者以改善预后。据我们所知，本研究首次在较大患者队列中提供了关于脊柱转移瘤SIB-SBRT治疗毒性及有效性的临床数据。
肿瘤(癌症)患者之家