This retrospective study analyzed data from over 600 patients and over 1400 spine segments treated with SBRT. Of these, 24 (4%) patients and 31 lesions (2.1%) received treatment to the posterior elements only with no coverage of the vertebral body. The cumulative rate of local failure was 9.7% at 12 months and 30.8% at 24 months. Paraspinal disease is a known risk factor for local recurrence, and indeed 73% of recurrences had paraspinal disease. Just over half of recurrences were completely within the original target while 45.5% were in adjacent but untreated sectors. Four of 5 failures adjacent to the target involved the vertebral body. The authors felt that the relative infrequency of vertebral body failure supported safety of not routinely including the uninvolved vertebral body with treating posterior elements with SBRT. | Burgess, Pract Radiat Oncol 2023
