Dexamethasone in the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases: a double-blind, randomised placebo-controlled, phase 3 trial

Chow, Edward; Meyer, Ralph M.; Ding, Keyue; Nabid, Abdenour; Chabot, Pierre; Wong, Philip; Ahmed, Shahida; Kuk, Joda; Dar, A. Rashid; Mahmud, Aamer; Fairchild, Alysa; Wilson, C. W.; Wu, Jackson; Dennis, Kristopher; Brundage, Michael; DeAngelis, Carlo; Wong, Rebecca

doi:10.1016/s1470-2045(15)00199-0

Cited by 138 publications

(63 citation statements)

References 28 publications

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“…[70] Dexamethasone has been shown to reduce radiation-induced pain flare in the treatment of painful bone metastases in a double-blind randomized control trial. [71]…”

Section: 4 Therapeutic Management Of Cibpmentioning

confidence: 99%

Bone Pain and Muscle Weakness in Cancer Patients

Milgrom

Lad

Koniaris

et al. 2017

Curr Osteoporos Rep

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Purpose of review In this article we will discuss the current understanding of bone pain and muscle weakness in cancer patients. We will describe the underlying physiology and mechanisms of cancer-induced bone pain (CIBP) and cancier-induced muscle wasting (CIMW), as well as current methods of diagnosis and treatment. We will discuss future therapies and research directions to help patients with these problems. Recent Findings There are several pharmacologic therapies that are currenly in pre-clinical and clinical testing that appear to be promising adjuncts to current CIBP and CIMW therapies. Such therapies include resiniferitoxin, which is a targeted inhibitor of nociptive nerve fibers, and selective androgen receptor modulators, which show promise in increasing lean mass. Summary CIBP and CIMW are a significant causes of morbidity in affected patients. Current management is mostly palliative; however, targeted therapies are poised to revolutionize how these problems are treated.

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“…[70] Dexamethasone has been shown to reduce radiation-induced pain flare in the treatment of painful bone metastases in a double-blind randomized control trial. [71]…”

Section: 4 Therapeutic Management Of Cibpmentioning

confidence: 99%

Bone Pain and Muscle Weakness in Cancer Patients

Milgrom

Lad

Koniaris

et al. 2017

Curr Osteoporos Rep

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“…16 Methods This is a secondary analysis of the NCIC Clinical Trials Group Symptom Control Trial SC.23 (NCIC-CTG-SC.23), which was an intent-to-treat, randomized, double-blind, phase 3 trial that investigated the use of dexamethasone for prophylaxis of pain flare after radiotherapy for painful bone metastases. 17 All patients were prescribed single 8-Gy (to convert to rads, multiply by 100) radiotherapy to 1 or 2 painful bone metastases. Patients were randomized to receive two 4-mg tablets of dexamethasone or 2 placebo tablets at least 1 hour before radiotherapy, then every day for 4 days after radiotherapy.…”

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confidence: 99%

Effect of Radiotherapy on Painful Bone Metastases

et al. 2017

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“…Yousef and El‐Mashad () compared the infusion of methylprednisolone with placebo given on day prior to the initiation of radiotherapy (30 Gy in 10 fractions) and found significant lower incidence of flare pain in the steroid group. The second study compared the administration of dexamethasone with placebo for patients treated with 8 Gy single fraction and reported significant reduction of the incidence of flare pain in the dexamethasone group (Chow et al., ).…”

Section: Resultsmentioning

confidence: 99%

The role of radiotherapy in bone metastases: A critical review of current literature

et al. 2017

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Radiotherapy is considered the treatment of choice for painful bone metastases. However, novel modalities of radiotherapy have emerged in the concept of oligometastasic disease. In addition, the increase of overall survival of patients with bone metastatic disease in the last decades due to systemic treatments has issued the silent topic of re-irradiation. The aim of this manuscript was to present a current thorough search of relevant literature. Originally, 6,087 articles revealed from PubMed database related to radiotherapy and bone metastases. The first objective was to identify prospective randomised phase III studies dealing with bone metastases and which treated primary with radiotherapy. Abstracts and non-English citations were excluded. Twenty-three phase III clinical trials, 17 prospective studies and eight meta-analysis/systemic reviews matching with these criteria, were identified. Eleven randomised studies were comparing single dose fraction to multi-fraction schedules of radiotherapy. The overall response rates and complete response rates were not significant between the two arms. Re-irradiations rates were significantly higher for the single dose fraction arms. Stereotactic radiotherapy showed excellent tumour control rates more than 80%. All trials showed the equivalence of either single or multi-fractionated radiotherapy for metastatic bone lesions. Stereotactic irradiation is feasible and safe for oligometastatic disease. However, it seems that the single fraction of 8 Gy is superior to 4 Gy, in terms of efficacy.

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Dexamethasone in the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases: a double-blind, randomised placebo-controlled, phase 3 trial

Cited by 138 publications

References 28 publications

Bone Pain and Muscle Weakness in Cancer Patients

Bone Pain and Muscle Weakness in Cancer Patients

Effect of Radiotherapy on Painful Bone Metastases

The role of radiotherapy in bone metastases: A critical review of current literature

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