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Single-Fraction Radiotherapy (SFRT) For Bone Metastases: Patient Selection And Perspectives

Authors Loi M, Nuyttens JJ, Desideri I, Greto D, Livi L

Received 16 July 2019

Accepted for publication 22 October 2019

Published 5 November 2019 Volume 2019:11 Pages 9397—9408


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Mauro Loi,1 Joost J Nuyttens,2 Isacco Desideri,1 Daniela Greto,1 Lorenzo Livi1

1Radiotherapy Department, University of Florence, Florence, Italy; 2Radiotherapy Department, Erasmus MC Cancer Center, Rotterdam, The Netherlands

Correspondence: Mauro Loi
Radiotherapy Department, University of Florence, L.go Brambilla 3, Florence 50100, Italy

Abstract: Bone metastases are a frequent and important source of morbidity in cancer patients. Stereotactic body radiation therapy (SBRT) is an established treatment option for local control and pain relief of bone metastases, and it is increasingly used as upfront treatment, postoperative consolidation or salvage treatment after prior RT. However, heterogeneity of dose schedules described in literature represents a severe limitation in the definition of the role of SBRT as a standard of care. No consensus is available on the use of single versus multiple fraction SBRT for bone metastases. Advantages of single-fraction SBRT include shorter overall duration of treatment, absence of inter-fraction uncertainty, improved compliance, theoretical increased efficacy, and lower costs. However, caution has been advised due to reports of severe late toxicities, in particular, vertebral collapse fracture (VCF). The aim of this paper is to review dose fractionation and indications for the management of bone metastases using SBRT.

Keywords: SBRT, stereotactic radiotherapy, radiosurgery, bone metastases, spine, non-spine

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