received travel expenses from Icotec research funding, travel expenses, honorarium for educational activity from Accuray travel expenses from Brain LAB honorarium for educational activity from NCCN is on data safety monitoring board for BioMimetix research funding from Canon received research funding and travel expenses from Elekta Sahgal also belongs to the Elekta MR Linac Research Consortium, Elekta Spine, Oligometastases and Linac Based SRS Consortia has been a consultant with Varian (Medical Advisory Group), Elekta (Gamma Knife Icon), BrainLAB, Merck, Abbvie, Roche Board Member to International Stereotactic Radiosurgery Society (ISRS) Advisory Board with VieCure Co-Chair with AO Spine Knowledge Forum Tumor received honorarium for past educational seminars with AstraZeneca, Elekta AB, Varian (CNS Teaching Faculty), BrainLAB, Medtronic Kyphon, Accuray research grant with Elekta AB, Varian and travel accommodations/expenses by Elekta, Varian and BrainLAB. On multivariate analysis, extraosseous disease extension was significantly associated with fracture ( P=0.001 subhazard ratio 10.8 95% CI 2.8-41.9) and local failure ( P=0.02 SHR 7.9 95% CI 1.4-44.7).Ī.S. The cumulative incidence of local failure (9/110 metastases with imaging follow-up) was 5.7%, 7.2% and 13.5% at 1, 2 and 3 years, respectively. The cumulative incidence of fracture was 3.5%, 6.1% and 9.8% at 1, 2 and 3 years, respectively.
In 6/8 patients, fracture was not associated with local failure. Eight fractures (5 in the femur, 2 in the tibia and 1 in the humerus) were observed with a median time to fracture of 12 months (range 0.8-33 months). The most common total doses were 30-50 Gy in 5 daily fractions (50.9%). Oligometastases accounted for 74.8% of metastases and 28.1% were osteolytic. There were 84 femur (73.7%), 26 humerus (22.8%) and 4 tibia (3.5%) metastases from prostate (45 ), breast (22 ), lung (15 ), kidney (13 ) and other (19 ) malignancies.
All but one patient had a Karnofsky performance status ≥70.
The median follow-up was 21 months (range 6-91 months).
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