Impact of target volume and dose concepts on the outcomes of prostate cancer patients treated with stereotactic body radiotherapy for spinal metastases − a European multicenter cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and purpose The importance of metastasis-directed radiotherapy is increasing in the management of oligometastatic prostate cancer. We evaluated different target volume and dose concepts for stereotactic body radiotherapy (SBRT) of spine bone metastases (BoM) from prostate cancer in a large European cohort. Material and methods Data of prostate cancer patients receiving SBRT for spine BoM between 2010 and 2024 at 19 European cancer centers were retrospectively collected. Treatment volumes and dose concepts were analyzed regarding their impact on overall survival (OS), freedom from local recurrence (FFLR), biochemical recurrence-free survival (BRFS), and progression-free survival (PFS). Results With a median follow-up of 25.1 months (range: 1.4–77.2), 213 patients with 283 spine BoM were evaluated. 1-/3-year PFS with simultaneously integrated boost (SIB) were 85.7 %/73.9 % (BED 4 [Biologically effective dose with α/β-ratio = 4 Gy] ≥ 100 Gy) and for non-SIB concepts 81.2 %/45.5 % (BED 4 ≥ 100 Gy), respectively. 1-/3-year BRFS for SIB-treated BoM amounted to 81.7 %/68.4 % (BED 4 ≥ 100 Gy) and for non-SIB 78.3 %/43.6 % (BED 4 ≥ 100 Gy). OS was not significantly different for the evaluated dose and target volume concepts. For FFLR a significant difference was observed favoring BED 4 ≥ 100 Gy. In multivariable analysis, following factors were positively associated with both PFS and BRFS: BED 4 for GTV mean dose and SIB concept. Adverse events were very low, with fracture rates of 2.2 %. Conclusion This multicenter cohort analysis showed that SBRT of spine BoM from prostate cancer is an effective and well-tolerated treatment. Both BED and usage of a SIB concept were associated with improved PFS and BRFS. Prospective studies are needed to confirm these findings and further standardize SBRT concepts.
Source: Radiotherapy and Oncology
Authors: Isabell Seiler, Sebastian Schäfer, Camilla von Wachter, Panagiotis Balermpas, Marek Slavik, Petr Burkon, Johannes Meents, Lena Kästner, Fabian Lohaus, Jochen Willner, Anna Sabrina Schunn, Sophia Drabke, Kenneth Klischies, Olaf Wittenstein, Priska Bank, Richard Partl, Jörg-Andreas Müller, Ahmed Gawish, Arne Grün, Andrea Baehr, Maike Trommer, Andrea Glasmacher, Thomas Mader, Richard Holy, Yvonne Dzierma, Felix Ehret, Alexander Rühle, Matthias Guckenberger, Christos Moustakis, Thomas Brunner, Oliver Blanck, Judit Boda-Heggemann, Nils H. Nicolay, Franziska Nägler
Institutions: University Hospital Leipzig, University Hospital Zurich, Masaryk University, Masaryk Memorial Cancer Institute, Heidelberg University, University Medical Centre Mannheim, Medizinische Fakultät Mannheim, German Cancer Research Center, Helmholtz-Zentrum Dresden-Rossendorf, University Hospital Carl Gustav Carus, Nationales Centrum für Tumorerkrankungen Dresden, Technische Universität Dresden, Bayreuth Medical Center, University Medical Center of the Johannes Gutenberg University Mainz, University Hospital Schleswig-Holstein, SRH Wald-Klinikum Gera, Medical University of Graz, University Hospital in Halle, Philipps University of Marburg, Universitätsklinikum Gießen und Marburg, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, University Medical Center Hamburg-Eppendorf, University of Bonn, University Hospital Bonn, University Hospital Cologne, Kantonsspital Graubünden, Universitätsmedizin Rostock
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,770
Funder: Universität Leipzig
OpenAlex ID: W4416040663