2017_SBRT_Course Book

Patterns of failure after spine SBRT Total Failures Adjacant vertebra Epidural Space Pedicles / posterior elements

33%

Ryu 2004

9 / 61

47%

17%

Chang 2007

17 / 74

0%

Gerszten 2007

6 / 51

0%

50%

50%

Nelson 2008

4 / 33

50%

33%

Nguyen 2010

12 / 55

Conclusions: • Safety of treating the involved vertebra only • Areas at risk: epidural space and untreated parts of vertebra

/ ESTRO SBRT 2017 - Matthias Guckenberger

07.09.17

23

Target volume concept of RTOG 0631

Anatomical target volume concept: • Inclusion of „volumes-at-risk“ in target volume • Exclusion of tumors within 3mm distance to spinal cord from practice of single fraction radiosurgery

/ ESTRO SBRT 2017 - Matthias Guckenberger

07.09.17

24