SBRS helps treat spine metastases

May 5, 2009

Stereotactic body radiosurgery (SBRS) extends survival and dramatically reduces pain and related symptoms of metastatic spine cancer, according to findings announced Wednesday to attendees of the American Association of Neurological Surgeons (AANS) annual meeting in San Diego.

Researchers from M. D. Anderson Cancer Center at the University of Texas in Houston reported that SBRS is a safe and effective treatment modality for this patient population.

Forty percent of all cancer patients develop spinal metastases, which are often painful and create neurological complications. Although conventional irradiation is useful for palliation, its effectiveness is limited by spinal cord tolerance to irradiation and, thus, can't be repeated, according to Dr. Eric Chang, associate professor of radiation oncology and director of M. D. Anderson's Stereotactic Spine Radiotherapy Program.

Chang and colleagues conducted a prospective study from 2002 through 2007 to evaluate the effectiveness of SBRS on cancer control and outcomes of 121 patients with spinal metastases. The study group included patients presenting with oligometastatic diseases, failure of prior conventional irradiation or surgery, a residual tumor after surgery, or a primary melanoma or renal cell carcinoma or sarcoma. Patients refusing surgery or those with medically inoperable cases were also included.

Results reported by the researchers included the following:

The six- and 12-month survival rates for spinal metastasis progression-free survival were 90% and 84%, respectively.
Patient survival was 65% at one year and 42% at two years (21 months median survival).
From a baseline of 27% of patients reporting no pain, complete pain relief increased to 45% one month following treatment and was 59% at six months.
Ten incidents of grade 3 toxicity were reported, with no late spinal cord complications.
Patients reported significant reduction in fatigue, pain, sleep disturbance, drowsiness, and distress six months after treatment.
No cases of radiation myelopathy have been observed.

Long-term survival possible after radiosurgery for brain metastases, January 12, 2006