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dc.contributor.authorRatnakumaran, R
dc.contributor.authorvan As, N
dc.contributor.authorKhoo, V
dc.contributor.authorMcDonald, F
dc.contributor.authorTait, D
dc.contributor.authorAhmed, M
dc.contributor.authorTaylor, H
dc.contributor.authorGriffin, C
dc.contributor.authorDunne, EM
dc.contributor.authorTree, AC
dc.coverage.spatialEngland
dc.date.accessioned2023-05-05T15:15:40Z
dc.date.available2023-05-05T15:15:40Z
dc.date.issued2023-05-01
dc.identifierS0936-6555(23)00024-9
dc.identifier.citationClinical Oncology, 2023, 35 (5), pp. 339 - 346
dc.identifier.issn0936-6555
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/5782
dc.identifier.eissn1433-2981
dc.identifier.eissn1433-2981
dc.identifier.doi10.1016/j.clon.2023.01.020
dc.description.abstractAIMS: Stereotactic body radiotherapy (SBRT) is increasingly used to treat sacral metastases. We analysed our centre's local relapse rates and patterns of failure after sacral SBRT and assessed whether using the consensus contouring recommendation (CCR) may have prevented local relapse. MATERIALS AND METHODS: We conducted a single-centre retrospective review of patients treated with sacral SBRT between February 2012 and December 2021. The cumulative incidence of local relapse, patterns of failure and overall survival were determined. Two investigators reviewed planning computed tomography scans and imaging at relapse to determine if local relapse was potentially preventable with a larger CCR-derived radiotherapy field. RESULTS: In total, 34 patients received sacral SBRT, with doses ranging from 24 to 40 Gy over three to five fractions. The most frequently used schedule was 30 Gy in three fractions. Common primaries treated included prostate (n = 16), breast (n = 6), lung (n = 3) and renal (n = 3) cancers. The median follow-up was 20 months (interquartile range 13-55 months). The cumulative incidence of local relapse (4/34) was 2.9% (95% confidence interval 0.2-13.2), 6.3% (95% confidence interval 1.1-18.5) and 16.8% (95% confidence interval 4.7-35.4) at 6 months, 1 year and 2 years, respectively. The patterns of failure were local-only (1/34), local and distant (3/34) and distant relapse (10/34). The overall survival was 96.7% (95% confidence interval 90.5-100) and 90.6% (95% confidence interval 78.6-100) at 1 and 2 years, respectively. For prostate/breast primaries, the cumulative incidence of local relapse was 4.5% (95% confidence interval 0.3-19.4), 4.5% (95% confidence interval 0.3-19.4) and 12.5% (95% confidence interval 1.7-34.8) at 6 months, 1 and 2 years, respectively. Twenty-nine cases (85.3%) deviated from the CCR. Sacral relapse was potentially preventable if the CCR was used in one patient (2.9% of the whole cohort and 25% of the relapsed cohort). DISCUSSION: We have shown excellent local control rates with sacral SBRT, which was largely planned with a margin expansion approach.
dc.formatPrint-Electronic
dc.format.extent339 - 346
dc.languageeng
dc.language.isoeng
dc.publisherELSEVIER SCIENCE LONDON
dc.relation.ispartofClinical Oncology
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectLocal control
dc.subjectoligometastases
dc.subjectpatterns of failure
dc.subjectsacrum
dc.subjectstereotactic body radiotherapy
dc.subjectMale
dc.subjectHumans
dc.subjectRadiosurgery
dc.subjectNeoplasms
dc.subjectSacrum
dc.subjectRetrospective Studies
dc.subjectRecurrence
dc.titlePatterns of Failure After Stereotactic Body Radiotherapy to Sacral Metastases.
dc.typeJournal Article
dcterms.dateAccepted2023-01-25
dc.date.updated2023-05-05T15:13:44Z
rioxxterms.versionAM
rioxxterms.versionofrecord10.1016/j.clon.2023.01.020
rioxxterms.licenseref.startdate2023-05-01
rioxxterms.typeJournal Article/Review
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/36805131
pubs.issue5
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Lung Radiotherapy
pubs.organisational-group/ICR/Students
pubs.organisational-group/ICR/Students/PhD and MPhil
pubs.organisational-group/ICR/Students/PhD and MPhil/22/23 Starting Cohort
pubs.publication-statusPublished
pubs.publisher-urlhttp://dx.doi.org/10.1016/j.clon.2023.01.020
pubs.volume35
icr.researchteamLung Radiotherapy
icr.researchteamClin Trials & Stats Unit
dc.contributor.icrauthorRatnakumaran, Ragu
dc.contributor.icrauthorGriffin, Clare
icr.provenanceDeposited by Mr Arek Surman on 2023-05-05. Deposit type is initial. No. of files: 1. Files: Patterns of Failure of sacral SBRT_final.pdf


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