Table 3.
Selected Studies Utilizing Hypofractonated SRS for Spine Metastases.a
| Author | Tumors, Pts | Histology (% Radioresistant) | Dose, Gy/Number Fractions | Follow-Up, months | Response | Survival |
|---|---|---|---|---|---|---|
| Park et al 48 | 59 (39) | Mixed (≥8.5) | 27/3 (median) | 7.4 (median) | 93.2% LC probability (1 year) | 47.4% (1 year) |
| Anand et al 49 | 76 (52) | Mixed (≥13.5) | 24-7/3 (for 71 lesions; 5 received 14-18/1) | 8.48 (median) | 94% LC (1 year) | 68% (1 year) |
| Bishop et al 50 | 332 (285) | Mixed (49) | 43 (median)/1-3 | 19 (median, 33 for living patients) | 88% LC (1 year) | 64% (1 year) |
| Bate et al 38 | 24 (hypofractonated SRS alone arm) | Mixed | 20-30/2-5 | 9.8 (median SRS alone) | 95.8% LC (1 year) | NR |
| Guckenberger et al 47 | 387 (301) | Mixed (≥35) | 24/3 (median, range 8-60/1-20) | 11.8 (median) | 89.9% LC (1 year) | 64.9% (1 year, median 19.5 months) |
| Thibault et al 51 | 71 (37) | RCC (100) | 24/2 (median) | 12.3 (median) | 83% LC (1 year) | 64% (1 year) |
| Sohn et al 52 | 13 (13) | RCC (100) | 38 (mean)/4 (median) | NR | 85.7% LC (1 year) | 15 months (median) |
| Folkert et al 40 | 52 (hypofractionation arm) | Sarcoma (100) | 28.5 (median)/3-6 | 12.3 (median including all arms) | 84.1% (12 months) | 46.2% (12 months) |
| Wang et al 46 | 166 (149) | Mixed (≥69) | 27-30/3 | 15.9 | 80.5% PFS (1 year) | 68.5% (1 year, median 23 months) |
| Gill et al 53 | 20 | Mixed (60) | 30/5 | 34 (median) | 80% LC (1 year) | 80% (1 year) |
| Ahmed et al 54 | 85 (66) | Mixed (≥52) | 24/3 (median) | 8.2 (mean) | 91.2% (1 year) without prior RT | 59% (1 year) without prior RT |
| Nguyen et al 55 | 55 (48) | RCC (100) | 27/3 (median) | 13.1 (median) | 82.1% PFS (1 year) 52% pain free (1 year) | |
| Sahgal et al 56 | 23 (14) without prior RT | Mixed (65) | 24/3 (median) | 9 (median) | 78% LC | NR |
| Nelson et al 57 | 33 (32) | Mixed (≥31) | 18/3 (median) | 6 (median) | 4 treatment failures | NR |
| Gibbs et al 58 | 102 (74) | Mixed | 16-25/1-5 | 9 (mean) | 84% improvement in symptomatic patients | 49% |
| Chang et al 45 | 74 (63) | Mixed (≥57) | 30/5 or 27/3 | 21.3 (median) | 84% PFS (1 year) | 69.8% (1 year, median survival 24.3 months) |
Abbreviations: LC, local control; NR, not reported; PFS, progression-free survival; pts, patients; RCC, renal cell carcinoma; SRS, stereotactic radiosurgery.
a Radioresistant indicates renal, thyroid, hepatocellular, colon, non-small cell lung carcinoma, sarcoma, and melanoma or as defined by study authors.