Spinal metastases: Is stereotactic body radiation therapy supported by evidences?

Critical Reviews in Oncology/Hematology

Volumn 98, Issue , 2016, Pages 147-158

  De Bari, Berardino ^a   Alongi, Filippo ^b   Mortellaro, Gianluca ^c   Mazzola, Rosario ^b,c   Schiappacasse, Luis ^a   Guckenberger, Matthias ^d  

^a LAUSANNE UNIVERSITY HOSPITAL   (Switzerland)

^b SACRO CUORE DON CALABRIA HOSPITAL   (Italy)

^c UNIVERSITY OF PALERMO   (Italy)

^d UNIVERSITY HOSPITAL ZURICH   (Switzerland)

Author keywords

Dosimetry; Local control; Palliative radiotherapy; SBRT; Spine metastases; Toxicity

Indexed keywords

CLINICAL EFFECTIVENESS; COMPRESSION FRACTURE; DIARRHEA; DOSIMETRY; DYSPHAGIA; ESOPHAGEAL TOXICITY; ESOPHAGUS DISEASE; ESOPHAGUS STENOSIS; FEASIBILITY STUDY; HUMAN; NEUROTOXICITY; NONCARDIAC CHEST PAIN; PATIENT SAFETY; PATIENT SELECTION; PERIPHERAL NEUROPATHY; RADIATION DERMATITIS; RADIATION INDUCED EMESIS; RADIATION SICKNESS; REVIEW; SPINAL CORD DISEASE; SPINAL CORD METASTASIS; SPINE FRACTURE; STEREOTACTIC BODY RADIATION THERAPY; THORAX PAIN; TREATMENT OUTCOME; ADVERSE EFFECTS; BONE NEOPLASMS; EVIDENCE BASED PRACTICE; FRACTURES, COMPRESSION; PALLIATIVE THERAPY; PATHOLOGY; RADIOSURGERY; RADIOTHERAPY DOSAGE; SECONDARY; SPINAL FRACTURES; SPINAL NEOPLASMS; STANDARDS; STATISTICS AND NUMERICAL DATA;

BONE NEOPLASMS; EVIDENCE-BASED PRACTICE; FRACTURES, COMPRESSION; HUMANS; PALLIATIVE CARE; RADIOSURGERY; RADIOTHERAPY DOSAGE; SPINAL FRACTURES; SPINAL NEOPLASMS; TREATMENT OUTCOME;

EID: 84957644772     PISSN: 10408428     EISSN: 18790461     Source Type: Journal    
DOI: 10.1016/j.critrevonc.2015.11.002     Document Type: Review

References (76)

1. Alongi F., Di Muzio N. Image-guided radiation therapy: a new era for the radiation oncologist?. Int. J. Clin. Oncol. 2009, 14:568-569.
2. Alongi F., Arcangeli S., Filippi A.R., Ricardi U., Scorsetti M. Review and uses of stereotactic body radiation therapy for oligometastases. Oncologist 2012, 17(8):1100-1107.
3. Alongi F., De Bari B., Campostrini F., Arcangeli S., Matei D.V., Lopci E., Petralia G., Bellomi M., Chiti A., Magrini S.M., Scorsetti M., Orecchia R., Jereczek-Fossa B.A. Salvage therapy of intraprostatic failure after radical external-beam radiotherapy for prostate cancer: a review. Crit. Rev. Oncol. Hematol. 2013, 88(December (3)):550-563.
4. Alongi F., De Bari B., Scorsetti M. Could single-high-dose radiotherapy be considered the new frontier of stereotactic ablative radiation therapy?. Tumori 2014, 100(May-June (3)):e92-3.
5. Atalar B., Aydin G., Gungor G., Caglar H., Yapici B., Ozyar E. Dosimetric comparison of robotic and conventional linac-based stereotactic lung irradiation in early-stage lung cancer. Technol. Cancer Res. Treat. 2012, 11(June (3)):249-255.
6. Available online at the electronic address: accessed online on 13.02.15. http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx%3Fstudy=0631.
7. Balagamwala E.H., Angelov L., Koyfman S.A., Suh J.H., Reddy C.A., Djemil T., Hunter G.K., Xia P., Chao S.T. Single-fraction stereotactic body radiotherapy for spinal metastases from renal cell carcinoma. J. Neurosurg. Spine 2012, 17(December (6)):556-564.
8. Bauman G., Rumble R.B., Chen J., Loblaw A., Warde P. Members of the IMRT Indications Expert Panel Intensity-modulated radiotherapy in the treatment of prostate cancer. Clin. Oncol. (R. Coll. Radiol.) 2012, 24(September (7)):461-473.
9. Benedict S.H., Yenice K.M., Followill D., Galvin J.M., Hinson W., Kavanagh B., Keall P., Lovelock M., Meeks S., Papiez L., Purdie T., Sadagopan R., Schell M.C., Salter B., Schlesinger D.J., Shiu A.S., Solberg T., Song D.Y., Stieber V., Timmerman R., Tomé W.A., Verellen D., Wang L., Yin F.F. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med. Phys. 2010, 37(August (8)):4078-4101. Erratum in: Med Phys 2012 Jan, 39(1):563.
10. Benzil D.L., Saboori M., Mogilner A.Y., Rocchio R., Moorthy C.R. Safety and efficacy ofstereotactic radiosurgery for tumors of the spine. J. Neurosurg. 2004, 101:413-418.
11. Cendales R., Vásquez J., Arbelaez J., Bobadilla I., Torres F., Gaitan A. IMRT, RapidArc® and conformal radiotherapy in the treatment of tumours of the anal canal. Ecancermedicalscience 2014, 6(October (8)):469. eCollection 2014. 10.3332/ecancer.2014.469.
12. Chambers A.F., Groom A.C., MacDonald I.C. Dissemination and growth of cancer cells in metastatic sites. Nat. Rev. Cancer 2002, 2(8):563-572.
13. Chang E.L., Shiu A.S., Mendel E., Mathews L.A., Mahajan A., Allen P.K., Weinberg J.S., Brown B.W., Wang X.S., Woo S.Y., Cleeland C., Maor M.H., Rhines L.D. Phase I/II study of stereotactic body radiotherapy for spinal metastasis and its pattern offailure. J. Neurosurg. Spine 2007, 7:151-160.
14. Chang U.K., Youn S.M., Park S.Q., Rhee C.H. Clinical results of cyberknife® radiosurgery for spinal metastases. J. Kor. Neurosurg. Soc. 2009, 46(6):538-544.
15. Chang U.K., Cho W.K., Kim M.S., Cho C.K., Lee D.H., Rhee C.H. Local tumor control after retreatment of spinal metastasis using stereotactic body radiotherapy; comparison with initial treatment group. Acta Oncol. 2012, 51:589-595.
16. Chao S.T., Koyfman S.A., Woody N., Angelov L., Soeder S.L., Reddy C.A., Rybicki L.A., Djemil T., Suh J.H. Recursive partitioning analysis index is predictive for overall survival in patients undergoing spine stereotactic body radiation therapy for spinal metastases. Int. J. Radiat. Oncol. Biol. Phys. 2012, 82(April (5)):1738-1743.
17. Chen A.M., Yu Y., Daly M.E., Farwell D.G., Benedict H.S., Purdy J.A. Long-term experience with reduced planning target volume margins and intensity-modulated radiotherapy with daily image-guidance for head and neck cancer. Head Neck 2014, 36(December (12)):1766-1772.
18. Chiang A., Zeng L., Zhang L., Lochray F., Korol R., Loblaw A., Chow E., Sahgal A. Pain flare is a common adverse event in steroid-naïve patients after spine stereotactic body radiation therapy: a prospective clinical trial. Int. J. Radiat. Oncol. Biol. Phys. 2013, 86(4):638-642.
19. Choi C.Y., Adler J.R., Gibbs I.C., Chang S.D., Jackson P.S., Minn A.Y., Lieberson R.E., Soltys S.G. Stereotactic radiosurgery for treatment of spinal metastases recurring in close proximity to previously irradiated spinal cord. Int. J. Radiat. Oncol. Biol. Phys. 2010, 78(October (2)):499-506.
20. Chow E., Zeng L., Salvo N., Dennis K., Tsao M., Lutz S. Update on the systematic review of palliative radiotherapy trials for bone metastases. Clin. Oncol. (R. Coll. Radiol.) 2012, 24(March (2)):112-124.
21. Cox B.W., Spratt D.E., Lovelock M., Bilsky M.H., Lis E., Ryu S., Sheehan J., Gerszten P.C., Chang E., Gibbs I., Soltys S., Sahgal A., Deasy J., Flickinger J., Quader M., Mindea S., Yamada Y. International spine radiosurgery consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. Int. J. Radiat. Oncol. Biol. Phys. 2012, 83(5):597-605.
22. Cunha M.V., Al-Omair A., Atenafu E.G., Masucci G.L., Letourneau D., Korol R., Yu E., Howard P., Lochray F., da Costa L.B., Fehlings M.G., Sahgal A. Vertebral compression fracture (VCF) after spine stereotactic body radiation therapy (SBRT): analysis of predictive factors. Int. J. Radiat. Oncol. Biol. Phys. 2012, 84(November (3)):e343-9.
23. Dai X., Zhao Y., Liang Z., Dassarath M., Wang L., Jin L., Chen L., Dong J., Price R.A., Ma C.M. Volumetric-modulated arc therapy for oropharyngeal carcinoma: A dosimetric and delivery efficiency comparison with static-field IMRT. Phys. Med. 2014, 2(October).
24. De Bari B., Chiesa S., Filippi A.R., Gambacorta M.A., D'Emilio V., Murino P., Livi L. AIRO (Italian Association of Radiation Oncology) and the AIRO Palliative Care Group. The INTER-ROMA project--a survey among Italian radiation oncologists on their approach to the treatment of bone metastases. Tumori 2011, 97(March-April (2)):177-184.
25. De Bari B., Alongi F., Buglione M., Campostrini F., Briganti A., Berardi G., Petralia G., Bellomi M., Chiti A., Fodor A., Suardi N., Cozzarini C., Nadia D.M., Scorsetti M., Orecchia R., Montorsi F., Bertoni F., Magrini S.M., Jereczek-Fossa B.A. Salvage therapy of small volume prostate cancer nodal failures: a review of the literature. Crit. Rev. Oncol. Hematol. 2014, 90(April (1)):24-35.
26. De Bari B., Fiorentino A., Arcangeli S., Franco P., D'Angelillo R.M., Alongi F. From radiobiology to technology: what is changing in radiotherapy for prostate cancer. Expert Rev. Anticancer Ther. 2014, 14(May (5)):553-564.
27. Dunlap N.E., Cai J., Biedermann G.B., Yang W., Benedict S.H., Sheng K., Schefter T.E., Kavanagh B.D., Larner J.M. Chest wall volume receiving <30Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2009, 76:796-801.
28. Fidler I.J. The pathogenesis of cancer metastasis: the seed and soil hypothesis revisited. Nat. Rev. Cancer 2003, 3(6):453-458.
29. Folkert M.R., Bilsky M.H., Tom A.K., Oh J.H., Alektiar K.M., Laufer I., Tap W.D., Yamada Y. Outcomes and toxicity for hypofractionated and single-fraction image-guided stereotactic radiosurgery for sarcomas metastasizing to the spine. Int. J. Radiat. Oncol. Biol. Phys. 2014, 88(April (5)):1085-1091.
30. Gagnon G.J., Nasr N.M., Liao J.J., Molzahn I., Marsh D., McRae D., Henderson F.C.Sr. Treatmentof spinal tumors using cyberknife fractionated stereotactic radiosurgery: pain and quality-of-life assessment after treatment in 200 patients. Neurosurgery 2009, 64:297-306.
31. Garg A.K., Shiu A.S., Yang J., Wang X.S., Allen P., Brown B.W., Grossman P., Frija E.K., McAleer M.F., Azeem S., Brown P.D., Rhines L.D., Chang E.L. Phase I/II trial of single session stereotactic body radiotherapy for previously un-irradiate. Spinal Metastases Cancer 2012, 118(20):5069-5077.
32. Gerszten P.C., Burton S.A., Ozhasoglu C., Vogel W.J., Welch W.C., Baar J., Friedland D.M. Stereotactic radiosurgery for spinal metastases from renal cell carcinoma. J. Neurosurg. Spine 2005, 3(October (4)):288-295.
33. Gerszten P.C., Burton S.A., Ozhasoglu C., Welch W.C. Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine (Phila Pa 1976) 2007, 32(January (2)):193-199.
34. Gerszten P.C., Sahgal A., Sheehan J.P., Kersh R., Chen S., Flickinger J.C., Quader M., Fahim D., Grills I., Shin J.H., Winey B., Oh K., Sweeney R.A., Guckenberger M. A multi-national report on methods for institutional credentialing for spine radiosurgery. Radiat. Oncol. 2013, 27(June (8)):158. 10.1186/1748-717X-8-158.
35. Gomez-Millan J., Fernández J.R., Medina Carmona J.A. Current status of IMRT in head and neck cancer. Rep. Pract. Oncol. Radiother. 2013, 18(October(6)):371-375.
36. Greco C., Zelefsky M.J., Lovelock M., Fuks Z., Hunt M., Rosenzweig K., Zatcky J., Kim B., Yamada Y. Predictors of local control after single-dose stereotactic image-guided intensity-modulated radiotherapy for extracranial metastases. Int. J. Radiat. Oncol. Biol. Phys. 2011, 79(4):1151-1157.
37. Guckenberger M., Sweeney R.A., Flickinger J.C., Gerszten P.C., Kersh R., Sheehan J., Sahgal A. Clinical practice of image-guided spine radiosurgery--results from an international research consortium. Radiat. Oncol. 2011, 6(December (15)):172.
38. Guckenberger M., Mantel F., Gerszten P.C., Flickinger J.C., Sahgal A., Létourneau D., Grills I.S., Jawad M., Fahim D.K., Shin J.H., Winey B., Sheehan J., Kersh R. Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis. Radiat. Oncol. 2014, 9(October (1)):226.
39. Hamilton A.J., Lulu B.A. A prototype device for linear accelerator-based extracranial radiosurgery. Acta Neurochir Suppl. 1995, 63:40-43.
40. Hamilton A.J., Lulu B.A., Fosmire H., Stea B., Cassady J.R. Preliminary clinical experience with linear accelerator-based spinal stereotactic radiosurgery. Neurosurgery 1995, 36(February (2)):311-319.
41. Heron D.E., Rajagopalan M.S., Stone B., Burton S., Gerszten P.C., Dong X., Gagnon G.J., Quinn A., Henderson F. Single-session and multisession CyberKnife radiosurgery for spine metastases-University of Pittsburgh and Georgetown University experience. J. Neurosurg. Spine 2012, 17(July (1)):11-18.
42. Jacobson A.F., Shapiro C.L., Van den Abbeele A.D., Kaplan W.D. Prognostic significance of the number of bone scan abnormalities at the time of initial bone metastatic recurrence in breast carcinoma. Cancer 2001, 91(January (1)):17-24.
43. Klish D.S., Grossman P., Allen P.K., Rhines L.D., Chang E.L. Irradiation of spinal metastases: should we continue to include one uninvolved vertebral body above and below in the radiation field?. Int. J. Radiat. Oncol. Biol. Phys. 2011, 81(December (5)):1495-1499.
44. Klish D.S., Grossman P., Allen K., Rhines L.D., Chang E.L. Irradiation of spinal metastases: should we continue to include one uninvolved vertebral body above and below in the radiation field?. Int. J. Radiat. Oncol. Biol. Phys. 2011, 81(5):1495-1499.
45. Koswig S., Budach V. Remineralization and pain relief in bone metastases after after different radiotherapy fractions (10 times 3Gy vs. 1 time 8Gy). A prospective study. Strahlenther. Onkol. 1999, 175(10):500-508.
46. Laufer I., Iorgulescu J.B., Chapman T., Lis E., Shi W., Zhang Z., Cox B.W., Yamada Y., Bilsky M.H. Local disease control for spinal metastases following separation surgery and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients. J. Neurosurg. Spine 2013, 18(March (3)):207-214.
47. Laufer I., Rubin D.G., Lis E., Cox B.W., Stubblefield M.D., Yamada Y., Bilsky M.H. The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist 2013, 18(June (6)):744-751.
48. Lutz S.T., Chow E.L., Hartsell W.F., Konski A.A. A review of hypofractionated palliative radiotherapy. Cancer 2007, 109(April (8)):1462-1470.
49. Mantel F., Glatz S., Toussaint A., Flentje M., Guckenberger M. Long-term safety and efficacy of fractionated stereotactic body radiation therapy for spinal metastases. Strahlenther. Onkol. 2014, 190(November (12)):1141-1148.
50. Maund I.F., Benson R.J., Fairfoul J., Cook J., Huddart R., Poynter A. Image-guided radiotherapy of the prostate using daily CBCT: the feasibility and likely benefit of implementing a margin reduction. Br. J. Radiol. Dec 2014, 87(December (1044)):20140459.
51. Mellon E.A., Javedan K., Strom T.J., Moros E.G., Biagioli M.C., Fernandez D.C., Wasserman S.G., Wilder R.B. A dosimetric comparison of volumetric modulated arc therapy with step-and-shoot intensity modulated radiation therapy for prostate cancer. Pract. Radiat. Oncol. 2015, 5(January-February (1)):11-15.
52. Nguyen Q.N., Shiu A.S., Rhines L.D., Wang H., Allen P.K., Wang X.S., Chang E.L. Managemen of spinal metastases from renal cell carcinoma using stereotactic body radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2010, 76(4):1185-1192.
53. Niibe Y., Chang J.Y. Novel insights of oligometastases and oligo-recurrence and review of the literature. Pulm. Med. 2012, 2012:261096.
54. Pan H., Simpson D.R., Mell L.K., Mundt A.J., Lawson J.D. A survey of stereotactic body radiotherapy use in the United States. Cancer 2011, 117(19):4566-4572.
55. Pan H.Y., Allen P.K., Wang X.S., Chang E.L., Rhines L.D., Tatsui C.E., Amini B., Wang X.A., Tannir N.M., Brown P.D., Ghia A.J. Incidence and predictive factors of pain flare after spine stereotactic body radiation therapy: secondary analysis of phase 1/2 trials. Int. J. Radiat. Oncol. Biol. Phys. 2014, 90(November (4)):870-876.
56. Peters S., Schiefer H., Plasswilm L. A treatment planning study comparing Elekta VMAT and fixed field IMRT using the Varian treatment planning system Eclipse. Radiat. Oncol. 2014, 10(July (9)):153.
57. Ricardi U., Filippi A.R., Franco P. New concepts and insights into the role of radiation therapy in extracranial metastatic disease. Expert Rev Anticancer Ther. 2013, 13(October (10)):1145-1155.
58. Rose P.S., Laufer I., Boland P.J., Hanover A., Bilsky M.H., Yamada J., Lis E. Risk of fracture after single fraction image-guided intensity-modulated radiation therapy to spinal metastases. J. Clin. Oncol. 2009, 30(October (30)):5075-5079.
59. Ryu S., Fang Yin F., Rock J., Zhu J., Chu A., Kagan E., Rogers L., Ajlouni M., Rosenblum M., Kim J.H. Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis. Cancer 2003, 97(8):2013-2018.
60. Ryu S., Pugh S.L., Gerszten P.C., Yin F.F., Timmerman R.D., Hitchcock Y.J., Movsas B., Kanner A.A., Berk L.B., Followill D.S., Kachnic L.A. RTOG 0631 phase 2/3 study of image guided stereotactic radiosurgery for localized (1-3) spine metastases: phase 2 results. Pract. Radiat. Oncol. 2014, 76-81.
61. Sahgal A., Ames C., Chou D., Ma L., Huang K., Xu W., Chin C., Weinberg V., Chuang C., Weinstein P., Larson D.A. Stereotactic body radiotherapy is effective salvage therapy for patients with prior irradiation of spinal metastases. Int. J. Radiat. Oncol. Biol. Phys. 2009, 74:723-731.
62. Sahgal A., Ma L., Gibbs I., Gerszten P.C., Ryu S., Soltys S., Weinberg V., Wong S., Chang E., Fowler J., Larson D.A. Spinal cord tolerance for stereotactic body radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2010, 77(June (1)):548-553.
63. Sahgal A., Atenafu E.G., Chao S., Al-Omair A., Boehling N., Balagamwala E.H., Cunha M., Thibault I., Angelov L., Brown P., Suh J., Rhines L.D., Fehlings M.G., Chang E. Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score. J. Clin. Oncol. 2013, 31(September (27)):3426-3431.
64. Sahgal A., Weinberg V., Ma L., Chang E., Chao S., Muacevic A., Gorgulho A., Soltys S., Gerszten P.C., Ryu S., Angelov L., Gibbs I., Wong C.S., Larson D.A. Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice. Int. J. Radiat. Oncol. Biol. Phys. 2013, 85(February (2)):341-347.
65. Schipani S., Wen W., Jin J.Y., Kim J.K., Ryu S. Spine radiosurgery: a dosimetric analysis in 124 patients who received 18Gy. Int. J. Radiat. Oncol. Biol. Phys. 2012, 84(December (5)):e571-6.
66. Sellin J.N.1, Reichardt W., Bishop A.J., Suki D., Rhines L.D., Settle S.H., Brown P.D., Li J., Rao G., Chang E.L., Tatsui C.E. Factors affecting survival in 37 consecutive patients undergoing de novo stereotactic radiosurgery for contiguous sites of vertebral body metastasis from renal cell carcinoma. J. Neurosurg. Spine 2015, 22(January (1)):52-59.
67. Sheehan J.P., Shaffrey C.I., Schlesinger D., Williams B.J., Arlet V., Larner J. Radiosur-gery in the treatment of spinal metastases: tumor control, survival, and qualityof life after helical tomotherapy. Neurosurgery 2009, 65:1052-1061.
68. Tang C., Hess K., Bishop A.J., Pan H.Y., Christensen E.N., Yang J.N., Tannir N., Amini B., Tatsui C., Rhines L., Brown P., Ghia A. Creation of a prognostic index for spine metastasis to stratify survival in patients treated with spinal stereotactic radiosurgery: secondary analysis of mature prospective trials. Int. J. Radiat. Oncol. Biol. Phys. 2015, 1(September (1)):118-125.
69. Timmerman R.D. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin. Radiat. Oncol. 2008, 18:215-222.
70. Tong D., Gillick L., Hendrickson F.R. The palliation of symptomatic osseous metastases: final results of the study by the rradiation therapy oncology group. Cancer 1982, 50(5):893-899.
71. Udrescu C., Jalade P., de Bari B., Michel-Amadry G., Chapet O. Evaluation of the respiratory prostate motion with four-dimensional computed tomography scan acquisitions using three implanted markers. Radiother. Oncol. 2012, 103(May (2)):266-269.
72. Van Oorschot B., Rades D., Schulze W., Beckmann G., Feyer P. Palliative radiotherapy--new approaches. Semin Oncol 2011, 38(June (3)):443-449.
73. Wang X.S., Rhines L.D., Shiu A.S., Yang J.N., Selek U., Gning I., Liu P., Allen P.K., Azeem S.S., Brown P.D., Sharp H.J., Weksberg D.C., Cleeland C.S., Chang E.L. Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1-2 trial. Lancet Oncol. 2012, 13(4):395-402.
74. Wu J.S., Wong R., Johnston M., Bezjak A., Whelan T. Cancer care ontario practice guidelines initiative supportive care group: meta-analysis of dose-fractionation radiotherapy trials for the palliation of painful bone metastases. Int. J. Radiat. Oncol. Biol. Phys. 2003, 55(3):594-605.
75. Yamada Y., Bilsky M.H., Lovelock D.M., Venkatraman E.S., Toner S., Johnson J., Zatcky J., Zelefsky M.J., Fuks Z. High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions. Int. J. Radiat. Oncol. Biol. Phys. 2008, 71(June (2)):484-490.
76. Zelefsky M., Greco C., Motzer R., Magsanoc J.M., Pei X., Locelock M., Mechalakos J., Zatcky Y.J., Fuks Z., Yamada Y. Tumo control outcomes after hypofractionated and single dose steretactic image guided intensity modulated radiotherapy for extracranial metastases from renal cell carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2012, 82(5):1744-1748.