Table 1.
Spine radiosurgical series through December 2010.
| Authors and year | Institution | No. of pts/ tx sites | Prior RT | Treatment system | Dose/fraction No./coverage | Spinal cord dose limits | Histology | Median F/U (in months) | Local control rate (percent) | Pain improved (percent) | Rate of myelopathy (percent) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Amdur et al., 2009 [39] | U of Florida | 21/25 | 12/21 | In house (Elekta Synergy-S) | 15 Gy/1/100% to 95% of PTV | 12 Gy to < 0 .1 cc, 5 Gy to < 0.5 cc if prior RT | Many | 8 | 24/25 (96%) | 6/14 (43%) | 0/21 (0 %) |
| Gerszten et al., 2006 [40] | U of Pittsburgh | 77/87 | 70/77 | CyberKnife | 20 Gy (mean)/1/80% IDL | 9 Gy max (mean), range: 4–12 Gy | Lung | 16 | 87/87 (100%) | 65/73 (89%) | 0/77 (0%) |
| Gerszten et al., 2005 [41] | U of Pittsburgh | 48/60 | 42/48 | CyberKnife | 20 Gy (mean)/1/80% IDL | 9.7 Gy max (mean), range: 2.4–14.0 Gy | Renal | 37 | 54/60 (90%) | 37/38 (97%) | 0/48 (0%) |
| Gerszten et al., 2005 [42] | U of Pittsburgh | 28/36 | 23/28 | CyberKnife | 21.7 Gy (mean)/1/80% IDL | >8 Gy to 0.3 cc (range: 0–0.7 cc) | Melanoma | 13 | 26/28 (93%) | 27/28 (96%) | 0/28 (0%) |
| Gerszten et al., 2005 [43] | U of Pittsburgh | 50/68 | 48/50 | CyberKnife | 19 Gy (mean)/1/80% IDL | 13 Gy max dose | Breast | 16 | 68/68 (100%) | 55/57 (96%) | 0/50 (0%) |
| Gerszten et al., 2007 [44] | U of Pittsburgh | 393/500 | 344/500 | CyberKnife | 20 Gy (mean)/1/80% IDL | NR | >50% breast, lung, melanoma, renal | 21 | 440/500 (88%) | 290/336 (86%) | 0/393 (0%) |
| Yamada et al., 2008 [45] | Memorial Sloan-Kettering | 93/103 | 0/93 | In house [46] | 24 Gy (median)/1/92% IDL (average) | 11.7 Gy max (median), range: 1.8–14 Gy | Many | 15 | 90% (actuarial at 1 year) | NR | 0/93 (0%) |
| Chang et al., 2007 [47] | MD Anderson | 63/74 | 35/63 | In house (Varian 21EX) | tx 1 : 6 Gy/5/80–90% of PTVtx 2 : 9 Gy/3/80–90% of PTV | 10 Gy max in 5 fractions for tx 1 9 Gy max in 3 fractions for tx 2 | Many (40% renal) |
21 | 84% (actuarial at 1 year) | NR | 0/63 (0%) |
| Ryu et al., 2007 [32] | Henry Ford Hospital | 177/230 | 0/177 | Brainlab Novalis system | 8–18 Gy/1/90% IDL | 9.2 Gy (mean) to <10% of cord volume | Many (25% breast) |
6 | NR | NR, 41/49 (84%) separate report [48] | 1/177 (0.5%) |
| Nelson et al., 2009 [49] | Duke U | 32/33 | 22/32 | In house (Varian 21EX) | 18 Gy (median)/3 (median)/ | 12 Gy to 1% of cord, BED <83 for retreatment | Many (31% renal) |
7 | 29/33 (88%) | 30/32 (94%) | 0/33 (0%) |
| Gibbs et al., 2007 [50] | Stanford U | 74/102 | 50/74 | Cyberknife | 16–25 Gy/1–5/77% IDL (mean), 98% of PTV | Max dose range 3–28 Gy in 1–5 fractions | >50% breast, lung, melanoma, renal | 9 | NR | 52/62 (84%, includes other neuro sxs) | 3/74 (4%) |
| Choi et al., 2010 [51] | Stanford U | 42/51 | 42/42 | Cyberknife | 20 Gy (median)/2 (median)/77% IDL (median) | 19.3 Gy max (median) in 1–5 fractions | >50% breast, lung | 7 | 38/51 (75%) | 15/23 (65%) | 1/41 |
| Degen et al., 2005 [52] | Georgetown U | 51/72 | 38/72 | Cyberknife | 21 Gy (mean)/3.6 (mean)/71% IDL (mean) | 11 Gy max (mean) to <1% of cord volume | Many (19% breast) | 12 | 69/72 (96%) | 37/38 (97.3%) | 0/51 (0%) |
| Gagnon et al., 2009 [53] | Georgetown U | 200/274 | 137/274 | Cyberknife | 21, 26.4 or 37.5 Gy/3, 3 or 5/75% IDL | NR | Many (18% breast) | 12 | NR | 55/152 (36%) became pain-free | 0/200 (0%) |
| Sahgal et al., 2009 [54] | UCSF | 39/60 | 25/39 | Cyberknife | 24 Gy/3/67% or 60% IDL (no RT or prev. RT) | 16.8 Gy or 12.8 Gy max (median) (no RT or prev RT) | Many | 9 | 85% (actuarial at 1 year) | NR | 0/39 (0%) |
Abbreviations: pts, patients; tx, treatment; F/U, followup; RT, radiation therapy; Gy, Gray; cc, cubic centimeter; PTV, planning target volume; IDL, isodose line; NR, not reported; BED, biologically equivalent dose.