Single-center study of stereotactic body radiation therapy for spinal metastases from gastrointestinal cancers

Metastases from gastrointestinal (GI) primary cancers are considered relatively radioresistant. A retrospective study at University of Pittsburgh (PA) Medical Center evaluated stereotactic body radation therapy (SBRT) for spinal metastases from GI cancers. Median follow-up was 5 months (IQR 1-13). Cumulative incidence rates of 3-, 6-, and 12-month local failure were 5%, 9%, and 10%, respectively. Rates of 3-, 6-, and 12-month overall survival were 68%, 50%, and 41%, respectively. Multivariable analysis showed epidural disease associated with inferior OS (HR 1.75; p=0.037). Complete or partial pain responses for tumors presenting with pain were 60%, 51%, 32%, and 32% after 1, 3, 6, and 12 months, respectively. Vertebral compression fractures following treatment developed in 9%, and radiation toxicity was observed in 11%, with no cases of neuropathy or myelopathy. The authors conclude that SBRT for GI cancer spinal metastases offers effective local tumor control and pain palliation with minimal toxicity.