Clinical Study on Stereotactic Body Radiotherapy for Spinal Metastasis Based on Volume Arc Intensity Modulated Radiation Therapy

Liu Miaomiao; Chen Xiaoliang; Mu Zhennuo

doi:10.3969/j.issn.1004-5775.2025.07.015

Abstract：Objective:To explore the clinical efficacy of stereotactic body radiotherapy(SBRT)based on volume arc intensity modulated radiation therapy(VMAT)in the treatment of spinal metastases.Methods:A retrospective analysis was conducted on the clinical data of 119 patients with spinal metastasis in hospitals from October 2019 to October 2022.They were divided into two groups based on different treatment plans.Among them,59 patients treated with intensity modulated radiation therapy(IMRT)and 60 patients treated with VMAT were used as the control group and the study group,respectively.The degree of spinal pain(NRS),degree of spinal cord injury(Frankle grade),toxic side effects,and quality of life(EORTC QLQ-BM22)were compared between two groups,and the survival status of the two groups were calculated.Results:The NRS scores of both groups showed a gradual downward trend from before radiotherapy to 3 months after radiotherapy.There was significant difference in NRS score between the two groups(F=630.174,P＜0.001).At the end of radiotherapy,Frankle grades of both groups were improved compared with those before radiotherapy,with statistical significance(Z=5.385,5.831;P＜0.05).The incidence of radiation pneumonia and myelosuppression in the study group was significantly lower than that in the control group(x2=4.555,4.627;P＜0.05).After radiotherapy,the EORTC QLQ-BM22 scores of both groups were lower than those before radiotherapy,and the difference was statistically significant(t=17.477,18.303;P＜0.001).Conclusion:The SBRT treatment plan based on VMAT technology is equivalent to IMRT technology in alleviating spinal pain,improving spinal cord injury,improving quality of life,and long-term survival in patients with spinal metastases,but VMAT technology has fewer toxic side effects.