Supplementary Material for: The importance of the importance of radiation planning guidelines in spinal SBRT

Stereotactic body radiotherapy (SBRT) employing intensity-modulated radiotherapy and image-guidance techniques has become the standard therapy for spinal metastases. SBRT for the spine attains a high local control (LC) rate (1 year: 90%) and has low toxicity (0.2% rate of neurologic injury).
Current guidelines by the International Spine Radiosurgery Consortium recommend CTV expansion based on the GTV location. The spine is divided into six sectors (vertebra, both pedicles, both transverse processes, and spinous process); and the CTV encompasses the sectors housing the GTV, along with adjacent sectors, accounting for subclinical tumor spread in the marrow space. Enforcing this standardized approach is imperative to achieve high LC rate.
Here; we present a case report of a patient treated at our institution, the aim of emphasizing the importance of adhering to current guidelines.