Image-guided robotic radiosurgery for spinal metastases.
OBJECTIVE
To determine the effectiveness and safety of image-guided robotic radiosurgery for spinal metastases.


METHODS
From 1996 to 2005, 74 patients with 102 spinal metastases were treated using the CyberKnife at Stanford University. Sixty-two (84%) patients were symptomatic. Seventy-four percent (50/68) of previously treated patients had prior radiation. Using the CyberKnife, 16-25 Gy in 1-5 fractions was delivered. Patients were followed clinically and radiographically for at least 3 months or until death.


RESULTS
With mean follow-up of 9 months (range 0-33 months), 36 patients were alive and 38 were dead at last follow-up. No death was treatment related. Eighty-four (84%) percent of symptomatic patients experienced improvement or resolution of symptoms after treatment. Three patients developed treatment-related spinal injury. Analysis of dose-volume parameters and clinical parameters failed to identify predictors of spinal cord injury.


CONCLUSIONS
Robotic radiosurgery is effective and generally safe for spinal metastases even in previously irradiated patients.
Gibbs
Iris C
IC
Department of Radiation Oncology, Stanford University, Stanford, CA 94305-5847, USA. iris.gibbs@stanford.edu
Kamnerdsupaphon
Pimkhuan
P
Ryu
Mi-Ryeong
MR
Dodd
Robert
R
Kiernan
Michaela
M
Chang
Steven D
SD
Adler
John R
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D012371:Robotics; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome