Stereotactic body radiotherapy for intramedullary metastases: a retrospective series at the Oscar Lambret center and a systematic review

• Published in: BMC cancer Vol. 21; no. 1; p. 1168
• Main Authors: Tonneau, Marion, Mouttet-Audouard, Raphaëlle, Le Tinier, Florence, Mirabel, Xavier, Pasquier, David
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.10.2021; BioMed Central; BMC
• Subjects: Adenocarcinoma - radiotherapy; Adenocarcinoma - secondary; Adenocarcinoma of Lung - radiotherapy; Adenocarcinoma of Lung - secondary; Adult; Aged; Breast cancer; Breast Neoplasms - pathology; Cancer Care Facilities; Cancer therapies; Carcinoma, Renal Cell - radiotherapy; Carcinoma, Renal Cell - secondary; Care and treatment; Case reports; Dose Fractionation, Radiation; Dosimetry; Female; Follow-Up Studies; France; Humans; Intramedullary metastasis; Kidney Neoplasms - pathology; Life Sciences; Literature reviews; Lung cancer; Lung Neoplasms - pathology; Magnetic resonance imaging; Male; Melanoma; Melanoma - radiotherapy; Melanoma - secondary; Metastases; Metastasis; Middle Aged; Neuro-oncology; Patient outcomes; Patients; Progression-Free Survival; Radiation therapy; Radiosurgery; Radiotherapy; Rare diseases; Retrospective Studies; SBRT; Skin cancer; Skin Neoplasms - pathology; Spinal cord; Spinal Cord Neoplasms - diagnostic imaging; Spinal Cord Neoplasms - mortality; Spinal Cord Neoplasms - radiotherapy; Spinal Cord Neoplasms - secondary; Standard deviation; Statistical analysis; Stereotactic; Survival; Systematic review; Toxicity; Tumor Burden; Tumors; France; Canada; Neuro-oncology; Radiotherapy; Stereotactic; Radiosurgery; SBRT; Intramedullary metastasis
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-021-08901-6

Intramedullary metastasis (IMM) is a rare disease with poor prognosis. The incidence of IMMs has increased, which has been linked to improved systemic treatment in many cancers. Surgery and/or radiotherapy are the most commonly used treatments; only small-sample retrospective studies and case reports on stereotactic body radiotherapy (SBRT) have reported acceptable results in terms of local control and clinical improvement, with no reported toxicity. Thus, we performed this monocentric retrospective study on five cases treated with SBRT for IMMs, which we supplemented with a systematic review of the literature. We included all patients treated for IMM with SBRT. The target tumor volume, progression-free survival, prescription patterns in SBRT, survival without neurological deficit, neurological functional improvement after treatment, and overall survival were determined. Five patients treated with a median dose of 30 Gy in a median number of fractions of 5 (prescribed at a median isodose of 86%) included. The median follow-up duration was 23 months. Two patients showed clinical improvement. Three patients remained stable. Radiologically, 25% of patients had complete response and 50% had stable disease. No significant treatment-related toxicity was observed. SBRT appears to be a safe, effective, and rapid treatment option for palliative patients.