Novalis Circle Symposium Focuses on Emerging Role of Stereotactic Radiosurgery for Patients with Spine Bone Metastasis

The Novalis® Circle hosted a symposium at this year’s American Society for Radiation Oncology (ASTRO) Annual Meeting to present and discuss topics related to stereotactic radiosurgery (SRS) treatment benefits in patients with spine metastasis. At the center of the scientific agenda, world-renowned experts highlighted current clinical evidence from leading institutions around the world who are at the forefront of improving pain management in spine disease. The growing benefit of stereotactic radiosurgery as up-front treatment for radio-resistant tumors or as part of multi-disciplinary care in conjunction with spine separation surgery were some of the new treatment paradigms highlighted by the speakers.

The scientific community is embracing the benefits of SRS, and two prospective randomized trials comparing SRS to External Beam Radiation Therapy (EBRT) in the treatment of metastatic spine disease were discussed at the Symposium as means to change current standards of care. Both studies, Radiation Oncology Therapy Group, (RTOG) 0631 and Canadian study SC24 aim to compare pain relief and quality of life between image guided radiosurgery SRS/SBRT and conventional external beam RT.

“The management of spine metastasis requires new therapies, and even access to combination therapies, that quickly and effectively manage the patient’s pain, control local disease and facilitate continuation of systemic treatments,” said Josh Yamada, MD, Radiation Oncologist, Memorial Sloan Kettering Cancer Center. “Modern clinical decision making not only needs to consider the neurologic and oncologic patient parameters, but also the spine mechanical stability and the overall control of systemic disease.”

Among other topics at the Symposium, first experiences with Elements Spine SRS* by Brainlab, the latest software application for automated spine tumor treatment planning, were presented.

* This product is not available for sale and will not be available until all applicable approvals have been acquired.

The software workflow is designed to address current challenges in spine radiosurgery planning, such as multi-modal image set registration accounting for spine curvature variations, automated clinical target definition based on International Spine Consortium Guidelines, and site-specific Monte Carlo VMAT planning aimed at improving the dose gradient interface between the tumor and spinal cord.

“As an early evaluator of the Brainlab technology, I find the software automation to render consistent radiosurgery plans and I’m especially impressed with its ability to dose paint high gradients of radiation in close proximity to the spinal cord,” said James L. Robar, PhD, Professor, Department of Radiation Oncology, Dalhousie University, Canada. “Elements Spine SRS is designed to help clinicians embrace radiosurgery strategies in the treatment of patients with spinal and paraspinal tumors.”