CyberKnife Known as High-Dose SBRT is More Effective for Painful Spine Metastases

by Oct 27, 2020Best CyberKnife Doctors, CyberKnife Center of Miami, CyberKnife News, CyberKnife Treatment for Pancreatic Cancer, Radiation Therapy, SBRT Therapy, Spinal Tumors

Roughly one-third of patients had a complete pain response at 3 and 6 months.
Two doses of palliative stereotactic body radiotherapy (SBRT) were more likely to completely eliminate spinal pain in patients with metastatic cancer compared to conventional radiotherapy (CRT), a phase II/III trial found.
In the study of over 200 patients with painful spinal lesions, complete pain response at 3 months was significantly improved in patients who received SBRT compared to controls (35% vs 15%, P<0.001), which was sustained at 6 months (32% vs 16%, P=0.004), reported Arjun Sahgal, MD, of Sunnybrook Odette Cancer Centre in Toronto.
“This is the first phase III randomized trial to show that dose escalation with modern radiotherapy techniques improves pain outcomes for patients with spinal metastases,” he said at a press briefing for the virtual American Society for Radiation Oncology (ASTRO) annual meeting. “Our regimen of 24 Gy in two SBRT fractions was safe, non-destabilizing, and associated with better patient financial perception.”
On multivariate analysis that adjusted for age, sex, tumor type, baseline spinal instability neoplasia score (SINS), performance status, and baseline pain score, SBRT was significantly associated with a higher likelihood of complete pain response at 3 months (odds ratio [OR] 3.47, 95% CI 1.77-6.80, P=0.0003) and again at 6 months (OR 2.45, 95% CI 1.28-4.71, P=0.007).
Both groups saw a “favorable” drop in mean total SINS at 3 months (-0.94 [SD 1.69] in the SBRT group and -0.49 [1.61] in the CRT group). These scores were nearly identical at 6 months (-0.74 [1.99] in the SBRT group and -0.73 [1.86] in the CRT group).
“Our regimen of 24 Gy in two SBRT fractions was safe, non-destabilizing, and associated with better patient financial perception.”
From 2016 to 2019, the phase II/III trial from the Canadian Cancer Trials Group (CCTG) and Trans Tasman Radiation Oncology Group (TROG) randomized 229 patients with painful spinal metastases 1:1 to either SBRT (24 Gy in two fractions) or standard palliative radiotherapy (20 Gy in five fractions). Median patient age was 63 and 65 years, respectively. Up to three contiguous spinal segments in the radiation treatment volume were allowed.
“There’s been some past controversy about this, and this is what I consider to be a practice-changing study,” said press briefing moderator Sue Yom, MD, of the University of California San Francisco.
“What I find really fascinating about this study is that on the quality-of-life surveys that were filled out by the patients, the financial perception of those receiving SBRT was superior, and this indicates that even a difference between two treatments and five treatments was a real quantifiable difference,” she said.
Patients in the SBRT group saw improved financial-oriented quality of life on the EORTC QLQ-C30 at 1 month (35% vs 23%) and were less likely to report worsening (15% vs 29%; P=0.034).
“Being able to have fewer treatments is significant to patients and that is an additional buttress to this study’s importance,” said Yom.
Inclusion criteria were pain scores of at least 2 on the Brief Pain Inventory, an Eastern Cooperative Oncology Group performance status of 0-2, and lesions that were not mechanically unstable on SINS.
The study’s primary endpoint was 3-month complete pain response. At the 3-month assessment, 35% of patients in the SBRT arm had a complete pain response, 18% had a partial pain response, and 24% had no change in their pain. In the control arm, these rates were 14%, 25%, and 30%, respectively.
At the 6-month assessment, 32% of patients in the SBRT arm had a complete response, 16% had a partial response, and 27% had no change. In the control arm, these rates were 16%, 9%, and 23%, respectively.
For disease control, 92% of patients in the SBRT group had no evidence of disease at the treated site at 3 months, compared with 86% of controls, a non-significant finding. Rates at 6 months were also similar (75% vs 69%, respectively). Overall survival was no different between the two arms.
Grade ≥2 adverse events were rare in the SBRT versus CRT groups, and included dysphagia (2% vs 0%, respectively), esophagitis (4% vs 2%), nausea (1% vs 3%), pain (6% vs 8%), fatigue (0% vs 1%), and vertebral compression fracture (1% in each). Vertebral compression fracture of any grade occurred in 11% of patients in the SBRT group and 17% of controls. No treatment-related deaths occurred.
For more information contact the CyberKnife Center of Miami and talk to our experts to determine if this noninvasive cancer treatment can help you or a loved one 305-279-2900 & go to our website now to learn more

CyberKnife Superior Treatment for Spinal Tumors

Any time you can avoid cutting into the spine to remove a tumor, you should consider doing so. If your doctor tells you it can’t be done. Get a second opinion from a CyberKnife expert.

Many men who die of prostate cancer don’t have to if they would just get regular prostate cancer screenings. And CyberKnife Radiation Therapy has a 97% cure rate.

Living Life to the Fullest While Battling Cancer That Keeps Spreading

When it comes to cancer we no longer look at it as stage 4 or 3 or 2. We treat all stages of cancer often buying patients precious time. What would you do with the extra life you are given?

What Are the Types of Lung Cancer Treatments?

Did you know that lung cancer kills three times as many men as prostate cancer and twice as many women as breast cancer? Those are staggering statistics when you think about it. Also, fewer than one in seven patients will be diagnosed while lung cancer is in its...

Brain Tumor Treatment In Miami Florida

CyberKnife Radiation Therapy is an alternative noninvasive treatment for brain tumors. There is no downtime, no cutting, no anesthesia. Treatment is done on an out patient basis. You lay down on the CyberKnife table, get treated and about 45 minutes later get up and get on with your day.

Single-Dose Radiotherapy for Breast Cancer Reduces Damage to Nearby Organs

There are safer ways to treat breast cancer that spare damage to the heart and lungs.

How Effective is Radiation Therapy for Lung Cancer?

The role of radiation therapy for lung cancer is constantly changing and evolving as techniques get more precise.  It used to be that radiation was limited to patients where surgery was not an option. But not anymore. Lung Cancer Treatment Options That’s because...

CyberKnife Brain Tumor Treatment vs Surgery

When ever you can it’s always best to avoid surgery. Today many tumors in the body, including the brain can be destroyed with CyberKnife Radiation Therapy

Breast Cancer Treatment With CyberKnife

CyberKnife Radiation Therapy can treat breast cancer in 1-to-5 sessions instead of 35 with other types of radiation. Plus it is more targeted therapy, greatly reducing the risk of damage to the lungs and heart. So why would you choose any other treatment option if you are a candidate for CyberKnife?

CyberKnife Treatment for Lung Cancer

Why would anyone risk major surgery to get rid of lung tumors when you can do it without surgery, noninvasively using CyberKnife Radiation Therapy which destorys lunng tumors with no downtime and very little risk of side effects?