• J Radiosurg SBRT · Jan 2015

    Risk of vertebral compression fracture specific to osteolytic renal cell carcinoma spinal metastases after stereotactic body radiotherapy: A multi-institutional study.

    • Isabelle Thibault, Eshetu G Atenafu, Eric Chang, Sam Chao, Al-Omair Ameen, Stephanie Zhou, Nicholas Boehling, Ehsan H Balagamwala, Marcelo Cunha, John Cho, Lilyana Angelov, Paul D Brown, John Suh, Laurence... more D Rhines, Michael G Fehlings, and Arjun Sahgal. less
    • Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada.
    • J Radiosurg SBRT. 2015 Jan 1; 3 (4): 297-305.

    PurposeDetermine the risk of vertebral compression fracture (VCF) following stereotactic body radiotherapy (SBRT), specific to osteolytic renal cell carcinoma (RCC) spinal metastases, and associated predictive factors.Methods187 RCC osteolytic spinal tumor segments in 116 patients obtained from a multi-institutional pooled database were reviewed. Each segment was evaluated according to the Spinal Instability Neoplastic Score (SINS).ResultsThe median follow-up was 8.0 months. 34 VCF (34/187, 18%) were observed and median time to VCF was 2.4 months. VCF was observed in 43% (10/23), 24% (4/17) and 14% (20/147) of segments treated with 24Gy/fraction (fx), 20-23Gy/fx and ≤19Gy/fx, respectively. Multivariate analysis identified dose per fx (p=0.005), baseline VCF (p<0.001) and spinal misalignment (p=0.002) as predictors of VCF. Prior conventional radiotherapy (p=0.029) was found to be protective.Conclusions18% of osteolytic RCC spinal metastases fractured post-SBRT. The presence of a baseline fracture, spinal mal-alignment and treatment with ≥20Gy/fx predicted for VCF.

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