2017_SBRT_Course Book
Dose and fractionation
Significantly improved LC after 5 x 6Gy Compared to 5 x 4Gy
Damast IJROBP 2010
Ø Use of fractionated protocols Ø 30Gy in 5 Fx, but still 25% recurrences within 12 months
ESTRO SBRT 2017 - Matthias Guckenberger
07.09.17
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Spine SBRT as re-treatment
# patients / cases
Dose 1st RT course (median)
Interval (median months)
Reirradiation TD / fraction (median)
Accumulated dose (median)
Study
Milker-Zabel 2003
18 / 19
38Gy 30Gy 36Gy 40Gy 30Gy 30Gy 30Gy 30Gy
18
39.6Gy / 22 30Gy / 15 24Gy / 3 20Gy / 2 30Gy / 10 20-30Gy / 5 27-30Gy / 3-5 24-30Gy / 3-5
NS
Mahan 2005 Sahgal 2009
8 / 8
NS
48Gy
25 / 37 42 / 51 36 / 36 94 / 97 59 / 63 60 / 81 49 / 54
11 19 18
NS
Choi 2010
76Gy 45Gy
Sterzing 2010 Damast 2010
NS NS
54.3Gy
Garg 2011
NS NS
Mahadevan 2011
20 25
Chang 2012
39.2Gy
27Gy / 3
83.4Gy
Evidence-based clinical practice: • 1 st RT course with ~30Gy and ~12 months interval • Fractionated re-irradiation: • 30Gy in 5 fractions • 3 / 5 studies did not assume spinal cord recovery
ESTRO SBRT 2017 - Matthias Guckenberger
07.09.17
24
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