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Vertebral Body Metastasis

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Adult CNS Radiation Oncology

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Abstract

Spinal metastasis is a common manifestation among cancer patients, and almost one-third develop neurological deficit. Several treatment modalities including surgical intervention, radiation treatment, and medical treatment should be tailored for the individual patient depending on the clinical situation using appropriate prognostic factors and a multidisciplinary treatment decision approach. Owing to rapid improvement in image-guidance and radiation delivery techniques, stereotactic body radiotherapy (SBRT) has emerged as a treatment of choice in selected patients due to its physical and biological advantages as well as proven clinical benefits. Given the risks inherent in delivering ablative doses of radiation within close proximity of critical structures such as the spinal cord, appropriate multidisciplinary treatment decision and radiation delivery technique are necessary. Durable local control and palliative benefit with limited toxicity can be achieved with spinal SBRT in appropriately selected patients.

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Abbreviations

AAPM:

The American Association of Physicists in Medicine

ASTRO:

American Society for Radiation Oncology

BED:

Biological equivalent dose

CBCT:

Cone beam CT

cEBRT:

Conventional external beam radiation treatment

CT:

Computed tomography

CTV:

Clinical target volume

EPID:

Electronic portal imaging device

GTV:

Gross target volume

IGRT:

Image-guidance radiotherapy

KPS:

Karnofsky performance status

KV:

Kilovoltage

LINAC:

Linear accelerator

LQ model:

Linear-quadratic model

MESCC:

Metastatic epidural spinal cord compression

MLC:

Multileaf collimator

MRI:

Magnetic resonance imaging

MV:

Megavoltage

OARs:

Organs at risk

OS:

Overall survival

P max :

Maximal point dose

PRISM:

Prognostic index for spine metastasis

PRV:

Planning organ-at-risk volume

PTV:

Planning target volume

QUANTEC:

Quantitative analysis of normal tissue effects in the clinic

RCC:

Renal cell carcinoma

RM:

Radiation myelopathy

RPA:

Recursive partitioning analysis

RT:

Radiotherapy

RTOG:

Radiation Therapy Oncology Group

SBRT:

Stereotactic body radiotherapy

SINS:

Spine Instability Neoplastic Score

TPD:

Time from primary diagnosis

VCF:

Vertebral compression fracture

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA

    Amol J. Ghia MD

  2. Department of Radiation Oncology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Anussara Prayongrat MD

Authors
  1. Amol J. Ghia MD
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  2. Anussara Prayongrat MD
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Corresponding author

Correspondence to Amol J. Ghia MD .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Keck School of Medicine of USC, Norris Cancer Hospital, Los Angeles, California, USA

    Eric L. Chang

  2. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA

    Paul D. Brown

  3. Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington, USA

    Simon S. Lo

  4. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Arjun Sahgal

  5. Department of Radiation Oncology, Taussig Cancer Institute Cleveland Clinic, Cleveland, Ohio, USA

    John H. Suh

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Ghia, A.J., Prayongrat, A. (2018). Vertebral Body Metastasis. In: Chang, E., Brown, P., Lo, S., Sahgal, A., Suh, J. (eds) Adult CNS Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42878-9_12

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