title: Postoperative Stereotactic Body Radiation Therapy (SBRT) for Spine Metastases: A Critical Review to Guide Practice.
abstract: Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beam radiation therapy and postoperative spine SBRT. Lastly, an in-depth practical discussion with respect to treatment planning and delivery considerations is provided to help guide optimal practice.
authors.affiliation: Department of Radiation Oncology, Johns Hopkins University, Baltimore, Maryland. Electronic address: kjanson3@jhmi.edu.
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Redmond
authors.affiliation: Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Lo
authors.affiliation: Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Fisher
authors.affiliation: Department of Radiation Oncology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods; D003131:Combined Modality Therapy / Q000592:standards; D019317:Evidence-Based Medicine; D006801:Humans; D038622:Internationality; D018579:Patient Selection; D011182:Postoperative Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D016634:Radiosurgery / Q000592:standards*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000592:standards; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D016896:Treatment Outcome