Risk of Fracture after IMRT to spinal met

[Olga]

When the bone met is located in a vertebrae, some treatment can be IMRT. New article from MSK talks about:

Risk of Fracture After Single Fraction Image-Guided Intensity-Modulated Radiation Therapy to Spinal Metastases
http://jco.ascopubs.org/content/27/30/5075.short?rss=1

They say:
Single-fraction image-guided intensity-modulated radiation therapy (IG-IMRT) allows for tumoricidal treatment of traditionally radioresistant cancers while sparing critical adjacent structures.
Conclusion: Vertebral fracture is common after single fraction IG-IMRT for metastatic spine lesions. Lytic disease involving more than 40% of the vertebral body and location at or below T10 confer a high risk of fracture, the presence of which yields significantly poorer clinical outcomes. These results may help clinicians identify high-risk patients who would benefit from prophylactic vertebro- or kyphoplasty.
My comment:
note that out of 62 consecutive patients the local tumor progression was only seen in seven patients so this plan of treatment (single dose of IMRT) in general has high rate of the local control.