SBRT for Uncomplicated Bone Metastases in the Spine from Lung Cancer

Abstract

Introduction: Bone metastases (BM) are common in several types of cancer, especially breast, prostate, lung, kidney and thyroid. Radiotherapy (RT) is a standard treatment for symptomatic BM, providing pain relief with minimal toxicity. Stereotactic body RT (SBRT) has emerged as an advanced technique to treat uncomplicated spinal bone metastases (UNSM) in patients with lung cancer. Methodology: A review of the scientific literature on the use of SBRT for UNSM was performed. The review included randomized controlled trials and meta-analyses, focusing on patient selection, treatment techniques and clinical outcomes. Inclusion criteria were defined, excluding imminent pathological fractures or spinal cord compression. Results: SBRT showed high rates of local control of metastases, reaching up to 90% in one year. There was significant pain relief and improvement in the quality of life of patients. Toxicities were minimal, with rare serious complications reported. Studies indicate that SBRT offers additional benefits, allowing dose escalation and minimizing toxicity compared to conventional RT. Discussion: SBRT is a promising approach to treat MONC, especially in patients with oligometastatic disease. Early detection and planned treatment of asymptomatic bone metastases can prevent serious complications, such as pathological fractures and spinal cord compression, improving pain-free survival. Current evidence supports the efficacy of SBRT, but prospective clinical trials are needed to optimize treatment protocols and patient selection. Multidisciplinary collaboration is essential for successful patient management. Conclusion: SBRT represents a significant advance in RT for uncomplicated spinal bone metastases in lung cancer, combining clinical efficacy and safety, with a positive impact on patients' quality of life. This innovative technique offers new therapeutic possibilities that should be considered in selected patients.