Stereotactic body radiotherapy for solitary spine metastasis
A 54-year-old man was diagnosed with renal cell carcinoma for which he underwent a nephrectomy in 2006, confirmed as pT3N0M0, stage III, without adjuvant therapy. Two years later a bone metastasis was detected in the T8 spine (), and the patient complained of severe back pain. His verbal/visual analogue scale (VAS) score was 8, and his Eastern Cooperative Oncology Group (ECOG) performance status was 1. We recommended vertebroplasty before radiosurgery because of a pathologic compression fracture in T8 spine, but the patient refused this. Radiosurgery was administered instantly, with a total dose of 24 Gy in 3 fractions, after which, the patient's pain improved with a VAS score of 3 and he required less than half the maximum dose of analgesics. Treatment with the oral chemotherapeutic agent, sunitinib has been continued. He was followed for 36 months until July 2011 without any evidence of recurrence or metastasis on positron emission tomographic-computed tomographic (PET-CT) and MRI scans. He was confirmed to be alive until November 2013, but we had no current information about him from the past 2 years because he subsequently transferred to a hospital near his home.