Risk Factors for Vertebral Compression Fractures After Stereotactic Radiotherapy for Spinal Metastases

Journal of Clinical Oncology

Vertebral compression fractures (VCF) are an adverse event after stereotactic body radiotherapy (SBRT) or radiosurgery for spinal metastases. A recent Journal of Clinical Oncology report retrospectively reviewed the SBRT experience at MD Anderson Cancer Center, Cleveland Clinic, and University of Toronto: 252 patients with 410 irradiated spinal segments were included, with up to 14% of the patients experiencing VCF after SBRT. Median time to VCF after radiation was 2.46 months. VCF risk factors include: doses >20 Gy, baseline VCF, lytic tumor, and pre-op spinal deformities. Moreover, the Spinal Instability Neoplastic Scoring System is useful for predicting the occurrence of post-SBRT VCF. The authors suggest caution in SBRT for metastases with doses >20Gy and frequent post-SBRT short-term follow-up.

Clark C. Chen, MD PhD
La Jolla, CA
Joseph D. Ciacci, MD
La Jolla, CA

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