Vertebral metastases reirradiation with volumetric-modulated arc radiotherapy

Pierina Navarria, Pietro Mancosu, Filippo Alongi, Sara Pentimalli, Angelo Tozzi, Giacomo Reggiori, Anna Maria Ascolese, Stefano Arcangeli, Francesca Lobefalo, Riccardo Rodriguez Y Baena, Simona Castiglioni, Federico Pessina, Flavio Tancioni, Armando Santoro, Antonella Fogliata, Luca Cozzi, Marta Scorsetti

Research output: Contribution to journalArticlepeer-review


Purpose: To assess the feasibility, acute toxicity, clinical improvement, local control and survival for spinal metastatic patients re-irradiated using volumetric-modulated-arc-radiotherapy (VMAT). Methods and materials: Between February 2009 and November 2010, 31 patients were treated. Surgery was performed in six before re-irradiation. The clinical target volume (CTV) was defined as the whole vertebrae with recurrence excluding the central section of spinal canal. Planning target volume was defined as CTV + 0-5 mm in the three directions. Dose was prescribed in order to have biological equivalent dose to the spinal cord from the two courses lower than 120 Gy 2 to 1 cc of the volume. Clinical improvement, toxicity and recurrence were evaluated. All patients had back pain before treatment and 15 (48%) neurological deficit. Results: Clinical remission of pain was obtained in 29 patients (93%). Neurological improvement was observed in 73% of patients. No acute or late toxicities were recorded. No recurrence occurred. Median survival was 10 months (range 6-24). At the last follow-up 19 patients (61%) were alive and 12 (39%) dead from systemic disease progression. The 1 and 2 year survival were 55% and 35%, respectively. Conclusion: In patients with spinal metastases recurrence re-irradiation with VMAT is feasible and provides clinical benefit in most patients.

Original languageEnglish
Pages (from-to)416-420
Number of pages5
JournalRadiotherapy and Oncology
Issue number3
Publication statusPublished - Mar 2012


  • Re-irradiation
  • Spinal metastases
  • Volumetric-modulated-arc-therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology


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