ArticleAdvances in radiation oncology2026
Risk Factors for Vertebral Compression Fracture Following Spine Stereotactic Body Radiation Therapy.
Article in Advances in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Purpose: Vertebral compression fractures (VCFs) are potential complications following spine stereotactic body radiation therapy (SBRT). However, limited data exist on prognostic factors underlying VCF development following SBRT. The objective of this clinical cohort investigation was to evaluate risk factors for VCF development, VCF type (de novo or progressive), and VCF severity, following SBRT for spinal metastases. Methods and Materials: A retrospective analysis was performed on a prospectively maintained database of 600 SBRT treatments (779 vertebral segments) for spinal metastases from 2002 to 2024. Exclusion criteria consisted of benign tumors, prior lesion-specific surgical intervention, and <1 month of follow-up. Logistic regression and Fine-Gray subdistribution hazard modeling was performed to evaluate predictors of VCF development. Results: The median follow-up was 8 months (range, 1-251 months). Fifty-seven (10%) VCFs were identified following SBRT: 29 (5%) de novo VCFs and 28 (5%) progressive VCFs. The median time-to-VCF was 6 months (range, 1-83 months). The 1- and 3-year cumulative incidence of VCF was 11% (95% CI, 8.1%-15%) and 21% (95% CI, 15%-27%), respectively. On multivariable analysis, female sex (odds ratio [OR], 1.06; 95% CI, 1.02-1.11; Conclusions: This large clinical cohort investigation successfully identified patient subgroups with increased risks of developing VCFs following spine SBRT for metastatic disease. Identifying these at-risk subpopulations may guide additional follow-up surveillance and consideration of individualized discussions regarding potential conservative or stabilization management approaches, particularly for those patients with multiple underlying risk factors.
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