Table 2.

Important clinical results following spine radiosurgery (based on recent prospective and retrospective data).

Author	Study design	SR indication	N / Dose	IGRT	Reported results
Ahmed et al. 55	Prospective case series	SM: primary and reirradiation	66 patients(85 lesions)24 Gy (SF and HF)	BodyFix or thoracic-T double vacuum system*ExacTrac X-ray system with a 6D robotic couch#	mOS (12 months): 52.2%LC (1 year): 91.2%No grade 4 toxicity
Amdur et al. 56	Prospective case series	SM: primary and reirradiation	21 patients(12 reirradiation)Dose: 15 Gy	Customizedbody mold / onboard cone-beam CT	OS (12 months): 60%43% pain reliefNo grade 3 or 4 toxicity
Garg et al. 57	Prospective case series	SM: primary SR	61 patients(63 tumors)16-24Gy (SF)	BodyFix / stereotactic localizer and target frame	LC (18 months): 88%?Supports SR as first-line treatment
Klish et al. 58	Prospective case series	SM: reirradiation	58 patientsDose: variable	BodyFix / stereotactic localizer and target frame	LC (12 months): 89.3%< 5% of isolated failures of the nonirradiated adjacent vertebral body = focal SR feasible
Garg et al. 45	Prospective case series	SM: reirradiation	59 patients(63 tumors)30 Gy (5 fractions)27 Gy (3 fractions)	BodyFix stereotactic body frame system / stereotactic localizer and target frame	OS (12 months): 76%LC (12 months): 100%Freedom from neurological injury: 92%
Gerszten et al. 22	Prospective nonrandomized cohort study	SM: primary and reirradiation	500 patients12.5 - 25 Gy (SF and HF)	CyberKnife: Aquaplast facemask$	LC: 90% of primary lesions and 88% of lesions treated for radiographic tumor progressionClinical improvement (previous neurologic deficit): 84%Long-term pain improvement: 86%
Haley et al. 59	Prospective case series	Efficacy and cost effectiveness of CRT versus SR	44 patients(22 CRT and 22 SR)Dose: variable	CyberKnife system	Similar pain reliefNo late complications in either groupCRT: more acute toxicities and was more likely to require additional interventions
Folkert et al. 32	Retrospective case series	SM: primary and reirradiation (sarcoma)	120 lesions(SF and HF 24 Gy)	Noninvasive customized cradle / onboard imaging (orthogonal KV imaging and cone-beam CT)	OS 60%LC (12 months) 87.9%Low toxicity reported
Zelefsky et al. 60	Retrospective case series	SM: primary and reirradiation (renal cell)	105 lesions(SF and HF)Dose: 24 Gy	Customized cradle / digitally reconstructed radiographs from the simulation studies for each field's beam's eye view	PFS (36 months - HF): 17%PFS (36 months -SF 24 Gy): 88%SF: improve local control

Legend: N: number of patients; IGRT: image-guided radiotherapy; SF: single fraction; HF: hypofractionated; SM: spine metastasis; Hypo: hypofractionated; LC: local control; OS: overall survival; PFS: progression-free survival; SR: spine radiosurgery; CRT: conventional radiotherapy; CT: computed tomography.

<?ENTCHAR ast?>: (Medical Intelligence, Schwabmunchen, Germany);

#(Brainlab, Feldkirchen, Germany);

%(Integra- Radionics Burlington, MA);

$(Aquaplast Corp., Wyckoff, NJ).