Stereotactic body radiotherapy for the treatment of spinal metastases

Introduction Spine stereotactic body radiation therapy (sSBRT) allows for the delivery of a high dose of radiation to spine metastases while respecting the dose limits of the adjacent spinal cord. In contrast with conventional radiation, the dose to spine metastases is limited by the spinal cord tolerance since the spinal cord is in the treatment field. sSBRT allows for reirradiation of spinal metastases, as well as higher doses to be delivered particularly for radioresistant metastases. It is also being used post laminectomy and decompressive surgery as primary treatment for malignant spinal cord compression instead of conventional external beam radiation therapy. Although experience and evidence are growing, variations in practice remain. Purpose We review the technical considerations and clinical applications of sSBRT.