An Easy Tool to Predict Survival in Patients Receiving Radiation Therapy for Painful Bone Metastases

Westhoff, Paulien G.; Graeff, Alexander de; Monninkhof, Evelyn M.; Bollen, Laurens; Dijkstra, Sander; Steen-Banasik, Elzbieta M. van der; Vulpen, Marco van; Leer, J.W.H.; Marijnen, Corrie A.M.; Linden, Yvette M. van der

doi:10.1016/j.ijrobp.2014.07.051

Cited by 64 publications

(56 citation statements)

References 36 publications

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“…Westhoff PG et al reported the results of 1157 patients which were treated with radiation therapy for painful bone metastases. In theirs study after maximum follow-up time of 35 months 74% patients died (compared to 3-year overall survival of 70% seen in investigated group) [30]. Results obtained in our group and in cited studies supports the conclusion made by Gerszten PC et al that stereotactic radiotherapy could prolongs patients life and provide better local control of the pain and disease compared to conventional radiotherapy [23].…”

Section: Discussionsupporting

confidence: 85%

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

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The aim of the study was to evaluate the effectiveness and toxicity of CyberKnife (CK) stereotactic radiosurgery (SRS) and stereotactic ablative radiation therapy (SABR) of patients with prostate cancer bone metastases. Analysis of prognostic and predictive factors was also performed.Material consisted of 51 patients with 71 bone oligometastases treated using CK SRS/SABR. In half of the patients single lesion was treated, in half 2-5 lesions. Median PSA concentration at the time of metastasis detection was 5.75 ng/ml. Total dose of 6-45Gy (median 20) was delivered with 1-5 fractions of 6-15 Gy (median 9). Biologic equivalent dose (BED) (α/ β=1.6) over 100 Gy was delivered to 45 lesions (63%) in 38 patients (75%).In statistical analysis Kaplan-Meier method, log-rank test and the Cox proportional hazard model were used. One-, two-and three-year overall survival (OS) was 90%, 76% and 70%, respectively. All patients having PSA concentration lower that 1 ng/ml at last control lived at least three years. One-, two-and three-year local control (LC) was 97%, 70% and 30%. Patients with PSA below 20 ng/ml at the time of metastasis detection had better local control of lesions and lower PSA at the last control. Median of PSA concentration after CK based SRS/SABR remains stable during first 12 months of follow-up, dropped during the next months and at last control was comparable to initial level. Median PSA at last control in patients without disease progression was 1.67ng/ml and 20 patients had PSA below 1.0ng/ml. At the last control 59% of patients had no other metastases. Rapid pain decrease was observed in analysed group and during each control about 90% of patients had pain relief. No major toxicity was observed, 3 patients suffered from fracture of irradiated bone. SRS/SABR of prostate cancer bone oligometastases provides good LC of lesions, excellent pain control without additional toxicity. Patients with PSA concentration below 20ng/ml at the time of metastasis detection have better LC and PSA concentration response.

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Section: Discussionsupporting

confidence: 85%

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

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“…Median survival for patients with bone metastases from lung cancer is three months, while this extends to ten months for prostate and 17 months for breast cancer. 15 Multiple factors are considered prognostic for survival besides primary tumour type and various prognostic models based on these factors have been designed, as shown in Table 1. 4,15,20 We advise the prediction of survival according to a simple and straightforward model, including primary tumour type, performance score, and the presence of visceral or cerebral metastases (Fig.…”

Section: Diagnosis and Evaluationmentioning

confidence: 99%

Treatment of pathological fractures of the long bones

et al. 2016

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Bone metastases of the long bones often lead to pain and pathological fractures. Local treatment consists of radiotherapy or surgery. Treatment strategies are strongly based on the risk of the fracture and expected survival.Diagnostic work-up consists of CT and biopsy for diagnosis of the primary tumour, bone scan or PET-CT for dissemination status, patient history and blood test for evaluation of general health, and biplanar radiograph or CT for evaluation of the involved bone.A bone lesion with an axial cortical involvement of >30 mm has a high risk of fracturing and should be stabilised surgically.Expected survival should be based on primary tumour type, performance score, and presence of visceral and cerebral metastases.Radiotherapy is the primary treatment for symptomatic lesions without risk of fracturing. The role of post-operative radiotherapy remains unclear.Main surgical treatment options consist of plate fixation, intramedullary nails and (endo) prosthesis. The choice of modality depends on the localisation, extent of involved bone, and expected survival. Adjuvant cement should be considered in large lesions for better stabilisation.Cite this article: Willeumier JJ, van der Linden YM, van de Sande MAJ, Dijkstra PDS. Treatment of pathological fractures of the long bones. EFORT Open Rev 2016;1:136–145. DOI: 10.1302/2058-5241.1.000008.

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“…However, this score may not be useful for extraspinal bone metastases (20). More recently, other scores for patients irradiated for bone metastases were created (21,22). One of these scoring systems was developed in patients with spinal and/or extraspinal bone metastases (21).…”

Section: Discussionmentioning

confidence: 99%

“…More recently, other scores for patients irradiated for bone metastases were created (21,22). One of these scoring systems was developed in patients with spinal and/or extraspinal bone metastases (21). Gender, primary tumor type, performance score, visceral metastases and two self-rating tools considering general health and quality of life were identified as significant prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Gender, primary tumor type, performance score, visceral metastases and two self-rating tools considering general health and quality of life were identified as significant prognostic factors. As this scoring system was very complex, a simpler system based only on performance score and primary tumor type was provided in the same report (21). Another scoring system was created from data of 1,043 patients with spinal metastases including only patients with MSCC (22).…”

Section: Discussionmentioning

confidence: 99%

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Interval Between Cancer Diagnosis and Radiotherapy – An Independent Prognostic Factor of Survival in Patients Irradiated for Bone Metastases from Kidney Cancer

Rades

Haus

Schild

2020

In Vivo

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Background/Aim: Cancer patients with metastatic disease require personalized treatment regimens. This study was performed to identify prognostic factors for overall survival (OS) following irradiation of bone metastases from kidney cancer. Patients and Methods: Data of 29 patients irradiated for bone metastases from kidney cancer were retrospectively evaluated. Ten factors were analyzed, including age, gender, performance score, interval from diagnosis of kidney cancer until radiotherapy for bone metastases, visceral metastases, other bone metastases, metastatic sites, number of irradiated sites, surgery of irradiated sites and systemic treatment prior to radiotherapy. Results: Using univariate analyses, a longer interval from diagnosis of kidney cancer radiotherapy was associated with better OS (p=0.012). Using Cox regression analysis, this factor remained significant (risk ratio=3.54, p=0.012). Conclusion: The interval from diagnosis of kidney cancer until radiotherapy is an independent prognostic factor associated with OS following irradiation of bone metastases from kidney cancer. This type of data can help personalize radiation programs.Cancer patients with metastatic disease require personalized treatment that meets the needs of each patient. This includes an assessment of the patient's expected remaining lifespan. For patients with a poor expected survival time, the 767 This article is freely accessible online.

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An Easy Tool to Predict Survival in Patients Receiving Radiation Therapy for Painful Bone Metastases

Cited by 64 publications

References 36 publications

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Treatment of pathological fractures of the long bones

Interval Between Cancer Diagnosis and Radiotherapy – An Independent Prognostic Factor of Survival in Patients Irradiated for Bone Metastases from Kidney Cancer

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