Table 3 Randomized trials on SBRT for spinal metastasesa
Name, institution | Start date, sample size | Patients | SBRT treatment | Comparator | Primary Endpoint |
|---|---|---|---|---|---|
Mahadevan et al. [36] Beth Israel Deaconess MC | 01–2012 81 | Number of sites not stated; Pain ≥ 5; No rapid neurologic decline | Total dose unknown in 1, 3, or 5 fractions; No more information provided | Standard EBRT in 10 fractions | Pain responseb |
RACOST [37] Radboud UMC Nijmegen | 06–2015 382 | Number of sites not stated; May have other visceral metastases; Pain ≥ 5; No neurologic deficit | Any modern system; 20 Gy in one fraction; Delineation with MRI and CT; Target volume is GTV, with bony CTV expansion, PTV margin ≤ 3 mm | Standard EBRT single dose of 8 Gy, no restrictions to radiation technique | Pain response taking administration of opioids into accountb |
RTOG 0631 [38] Henry Ford Hospital | 11–2011 395 | Up to 3 spinal sites; May have other visceral metastases; Pain ≥ 5; No rapid neurologic decline | IMRT or other dose painting technique; 16 or 18 Gy in one fraction; Delineation with MRI and CT; Target volume is involved VB | Standaard EBRT single dose of 8 Gy, 2D and 3D conformal therapy | Pain response (increase or decrease of ≥ 3 points) at 3 months |
SMART [39] Heidelberg University | 12–2014 60 | Up to 2 spinal sites; No neurologic deficit | IMRT; 24 Gy in one fraction; Delineation with CT; Target volume is involved VB with PTV margin | Standard EBRT 30 Gy in 10 fractions, 3D conformal planning | Pain response (increase or decrease of > 2 points) at 3 months |
SPIN-MET [40] University of Erlangen-Nürnberg | 03–2013 155 | Number of sites not stated; May have other visceral metastases; No rapid neurologic decline | 36 Gy in 12 fractions plus integrated boost 48 Gy in 12 fractions; No more information provided | Conventional EBRT 30 Gy in 10 fractions | Tumor control defined as time to progression on MRI |
Tingting et al. [41] Cancer Hospital of Shantou UMC | 03–2014 100 | Up to 3 spinal sites | 24 Gy in 2 fractions; No more information provided | Conventional EBRT 30 Gy in 10 fractions | Pain response taking administration of opioid into accountb |
VERTICAL University Medical Center Utrecht | 01–2015 110 | Up to 2 spinal sites; May have other visceral metastases; Pain ≥ 3; no rapid neurologic decline | VMAT; 18 Gy in one fraction or fractionated equivalent; Delineation with MRI and CT; Target volume with simultaneous integrated boost | Standard of care for standard radiotherapy | Pain response (increase or decrease of ≥ 2 points) taking administration of opioid into account at 3 months |