title: Stereotactic radiosurgery and stereotactic fractionated radiotherapy for metastatic tumors of the spine.
abstract: OBJECTIVE
  The objectives of this paper are to describe pain control, neurologic improvement, local tumor control, progression-free survival, and overall survival of spine SRS/SFRT patients, and to compare our outcomes with other studies on spine stereotactic radiotherapy for metastatic tumors.
  
  
  METHODS
  A chart review of patients who underwent spine SRS/SFRT was done. Information was collected on patient age, sex, histology, site treated, pain relief, local control, neurologic function, prescription dose, and complications. Descriptive statistics, median local control rates, progression-free survival, and overall survival were calculated.
  
  
  RESULTS
  Twenty eight SRS and 3 SFRT target volumes in 21 patients were studied. Eighteen underwent SRS and 3 underwent SFRT for metastasis from August 2012 to February 2016. Follow-up ranged from 4 to 41 months. Average dose was 16.6 ± 3.9 Gy. Spine SRS mean target volume was 31.1 cc (95% CI, 21.7-40.6 cc). Median overall survival after treatment was 16 months (95% CI, 9.7-22.3 months) and median progression-free survival was 13 months (95% CI, 8.4-17.6 months). Local control was 46%, 30%, and 15% at 6, 8, and 10 months, respectively. Average onset of pain relief is 4.9 days (95% CI, 0.8-8.9 days). One patient (5%) developed post SRS vertebral compression fracture.
  
  
  CONCLUSIONS
  SRS/SFRT is a safe and effective alternative to EBRT for the treatment of spine metastasis. Improvement in pain control and motor strength and incidence of adverse events are comparable with other studies. Local tumor control was lower in our series due to a lower mean prescribed dose.
authors.affiliation: a Section of Neurosurgery , Institute for Neurosciences, St. Luke's Medical Center - Global City , Taguig , Philippines.
authors.forename: Juan Manuel L
authors.initials: JM
authors.lastname: Mariano
authors.affiliation: a Section of Neurosurgery , Institute for Neurosciences, St. Luke's Medical Center - Global City , Taguig , Philippines.
authors.forename: Erickson F
authors.initials: EF
authors.lastname: Torio
authors.affiliation: b Department of Health , Health Policy Development and Planning Bureau , Taguig , Philippines.
authors.forename: Ma Socorro S D
authors.initials: MS
authors.lastname: Santos
authors.affiliation: c Advanced Spine Care Service and Section of Neurosurgery, Institute for Neurosciences , St. Luke's Medical Center - Global City , Taguig , Philippines.
authors.forename: Ibet Marie Y
authors.initials: IM
authors.lastname: Sih
authors.affiliation: d Brain Tumor Center and Section of Neurosurgery, Institute for Neurosciences , St. Luke's Medical Center - Global City , Taguig , Philippines.
authors.forename: Roy Allan Dominique G
authors.initials: RA
authors.lastname: Torcuator
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000503:physiopathology / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D013125:Spinal Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Spine metatases; cost; dose; local tumor control; stereotactic fractionated radiotherapy; stereotactic radiosurgery