title: Management of spinal metastases from renal cell carcinoma using stereotactic body radiotherapy.
abstract: OBJECTIVE
  To evaluate the outcomes associated with stereotactic body radiotherapy (SBRT) in the management of spinal metastases from renal cell carcinoma (RCC).
  
  
  METHODS
  SBRT was used in the treatment of patients with spinal metastases from RCC. Patients received either 24 Gy in a single fraction, 27 Gy in three fractions, or 30 Gy delivered in five fractions. Effectiveness of SBRT with respect to tumor control and palliation of pain was assessed using patient-reported outcomes.
  
  
  RESULTS
  A total of 48 patients with 55 spinal metastases were treated with SBRT with a median follow-up time of 13.1 months (range, 3.3-54.5 months). The actuarial 1-year spine tumor progression free survival was 82.1%. At pretreatment baseline, 23% patients were pain free; at 1 month and 12 months post-SBRT, 44% and 52% patients were pain free, respectively. No Grade 3-4 neurologic toxicity was observed.
  
  
  CONCLUSIONS
  The data support SBRT as a safe and effective treatment modality that can be used to achieve good tumor control and palliation of pain associated with RCC spinal metastases. Further evaluation with randomized trials comparing SBRT to conventional radiotherapy may be warranted.
authors.affiliation: Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Quynh-Nhu
authors.initials: QN
authors.lastname: Nguyen
authors.forename: Almon S
authors.initials: AS
authors.lastname: Shiu
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Rhines
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Allen
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Eric L
authors.initials: EL
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D013125:Spinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*