SBRT in non-spine bone metastases: a literature review
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REVIEW ARTICLE
SBRT in non‑spine bone metastases: a literature review Carolina De la Pinta1 Received: 29 August 2020 / Accepted: 14 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Stereotactic Body Radiotherapy (SBRT) is a technique for delivering high doses of radiation to tumors while preserving the normal tissues located around this area. Bone metastases are frequent in cancer patients. They can be distressingly painful or may cause pathological fractures. Radiation therapy is a fundamental aspect of treatment for bone metastases. The objective of this study is to analyze the literature on non-spine bone metastasis treated with SBRT, including immobilization, volume delineation, dose and fractionation, local control, side effects, and assessment of response after treatment. Full-text articles written in English language and published in the last 10 years were included in this review and were accessible on PubMed and MEDLINE. We examined 78 articles. A total of 40 studies were included in this review. Most were retrospective studies. The articles included were evaluated for content and validation. The immobilization systems and imaging tests used for tumor delimitation were variable between studies. The use of CTV (Clinical Target Volume) has not been defined. Doses and fractions were variable from 15 to 24 Gy/1 fraction to 24–50 Gy in 3–5 fractions, with local control being around 90% with a low rate of side effects. We review state of the art in SBRT non-spine metastases. SBRT can result in better local control and pain management in non-spine bone metastases patients. We need more research in volume delineation determining whether or not to use CTV and the role of MRI in volume contouring, optimal doses, and fractionation according to histology and a reliable response assessment tool. Studies that compare SBRT to conventional radiotherapy in local control and pain control are needed. Keywords SBRT · SABR · Bone metastases · Non-spine bone metastases
Introduction Bone is a frequent site of metastasis, and radiotherapy is an effective treatment for the symptomatic control of pain caused by metastasis [1]. The development of SBRT has allowed practicing physicians to administer high doses per fraction (or a limited number of fractions) with adequate control of pain. This consequently led to improvement in the quality of life of these patients while at the same time the side effects were reduced along with the possibility of reirradiation. In addition, in asymptomatic oligometastatic or oligoprogressive patients, this treatment modality may allow the prolongation of the systemic treatment line and increase progression-free survival or overall survival of patients [2]. The implementation of high-precision irradiation techniques, such as stereotactic body radiotherapy (SBRT, * Carolina De la Pinta [email protected] 1
Radiation Oncology, Ramon y Cajal Hospital, Madrid, Spain
Stereotactic Body RadioTherapy, or SABR, Stereotactic Ablative RadioTherapy), has had
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