ESTRO-ISRS clinical practice recommendations for re-irradiation of spinal metastases with Stereotactic Body Radiotherapy: Delphi consensus supported by a systematic review and meta-analysis
Rattachement africain : it, us, ca, gb, nl, se, de, ch. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Stereotactic body radiotherapy (SBRT) is an established treatment for previously unirradiated spinal metastases; however, the literature is limited with respect to SBRT as a re-irradiation salvage therapy. We performed a systematic review and meta-analysis as basis for joint ESTRO-ISRS clinical practice recommendations of salvage SBRT for spinal metastases. METHODS: A systematic review and meta-analysis were performed using PRISMA methodology, including publications from January 2006 to September 2024, reporting on the clinical outcomes of ≥ 5 patients treated with spine SBRT re-irradiation (≥5 Gy per fraction) for vertebral metastases. These data served as basis for joint ESTRO-ISRS clinical practice recommendations. RESULTS: After the initial article screen, 20 studies (5 prospective, 15 retrospective) met the inclusion criteria for analysis. A total of 1538 spine metastases were treated in 1284 patients. The median re-irradiation dose was 24 Gy in 2 fractions (range: 16-30 Gy in 1-5 fractions) after a median 30 Gy in 10 fractions of prior conventional radiotherapy. Vertebral compression fracture, nerve root damage, and myelopathy events were observed in a pooled proportion of 5.0 %, 5.6 %, and 1.7 %, respectively. With a median follow-up of 12 months, the pooled 1- and 2-year LC rates were 81 % (95 % CI: 77-86 %) and 70 % (95 % CI: 61-79 %), respectively. Despite the low level of evidence, a consensus was reached after the first round of voting for 11 practice recommendations, suggesting a substantial level of agreement among the experts. CONCLUSIONS: Re-irradiation with SBRT for spine metastases following prior conventional radiation or SBRT was efficacious, safe, and is a recommended treatment option in appropriately selected patients. Joint practice recommendations are provided on behalf of ESTRO and ISRS to guide clinical practice.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- ESTRO-ISRS clinical practice recommendations for re-irradiation of spinal metastases with Stereotactic Body Radiotherapy: Delphi consensus supported by a systematic review and meta-analysis
- Date Crossref
- 01/01/2026
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Ospedale Sacro Cuore Don Calabria pays non établi dans la noticeÉtablissement de santé
-
Azienda di Rilievo Nazionale ed Alta Specializzazione pays non établi dans la noticeÉtablissement de santé
-
Baptist Hospital of Miami pays non établi dans la noticeÉtablissement de santé
-
Baptist Health South Florida pays non établi dans la noticeÉtablissement de santé
-
Università degli Studi di Enna Kore pays non établi dans la noticeUniversité ou école supérieure
-
Sunnybrook Health Science Centre pays non établi dans la noticeÉtablissement de santé
-
University of Toronto Department of Radiation Oncology pays non établi dans la noticeUniversité ou école supérieure
-
Health Sciences Centre pays non établi dans la noticeÉtablissement de santé
-
University of California pays non établi dans la noticeUniversité ou école supérieure
-
Istituto Neurologico Mediterraneo pays non établi dans la noticeÉtablissement de santé
-
Royal Marsden NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
-
Amsterdam University Medical Centers pays non établi dans la noticeÉtablissement de santé
Ospedale Sacro Cuore Don Calabria, Azienda di Rilievo Nazionale ed Alta Specializzazione et Baptist Hospital of Miami, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.