The long of it.

How safe is stereotactic body radiation therapy (SBRT) for long-bone metastases? With few critical structures at risk, the main concern with SBRT in this scenario is fracture. In this retrospective study, 111 patients with 114 long-bone metastases were treated with SBRT. Most (58/8%) had prostate or breast cancer, and most also (74.8%) had oligometastatic disease. A variety of dose/fractionation schemes were used including 30-50 Gy in 5 fractions (50.9%), 18-24Gy in 1 fraction (27.2%), and 24-39 Gy in 3 fractions (14.9%). The median BED10 to the target was 56.7Gy. The local failure rate at 2 years was just 7.2%. Extraosseous disease was associated with an increased risk of local failure. Fracture occurred in 7% of patients (5 femur, 2 tibia, 1 humerus). While only a quarter of fractures were associated with local failure, extraosseous disease extension was also the only factor associated with an increased risk of fracture. Nevertheless, SBRT for long-bone metastases has a high rate of local control and low risk of fracture. | Madani, Int J Radiat Oncol Biol Phys 2022