Fractionated half-body irradiation (HBI) for the rapid palliation of widespread, symptomatic, metastatic bone disease: a randomized Phase III trial of the International Atomic Energy Agency (IAEA)

Salazar, Omar M.; Sandhu, Taljit S.; Motta, Neiro Waechter da; Escutia, M.A. Pérez; Lanzós-Gonzales, Eduardo; Mouelle-Sone, A; Moscol, Alfredo; Zaharia, Mayer; Zaman, S

doi:10.1016/s1278-3218(02)00179-8

Cited by 17 publications

(34 citation statements)

References 2 publications

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“…When larger or multiple fields of irradiation are necessary (such as for multiple metastases in the vertebra and in the pelvis), bone marrow suppression increases and is visualized by a shift from active red to fibrous yellow bone marrow on magnetic resonance imaging in irradiated bones. Hence, widefield external irradiation in patients with disseminated skeletal metastases is not frequently used and is also associated with significant acute gastrointestinal toxicity (16).…”

Section: Radiotherapymentioning

confidence: 99%

High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the α-Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities?

Bruland

Nilsson²,

Fisher

et al. 2006

Clinical Cancer Research

314

224

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The bone-seeking, a-particle-emitting radiopharmaceutical Alpharadin, 223 RaCl 2 (half-life = 11.4 days), is under clinical development as a novel treatment for skeletal metastases from breast and prostate cancer. This article summarizes the current status of preclinical and clinical research on Ra dosimetry in mice and a therapeutic study in a skeletal metastases model in nude rats have indicated significant therapeutic potential of bone-seeking a-emitters. This article provides short-term and long-term results from the first clinical single dosage trial. We also present data from a repeated dosage study of five consecutive injections of 50 kBq/kg body weight, once every 3rd week, or two injections of 125 kBq/kg body weight, 6 weeks apart. Furthermore, interim results are described for a randomized phase 2 trial involving 64 patients with hormone-refractory prostate cancer and painful skeletal metastases who received four monthly injections of 223 Ra or saline as an adjuvant to external beam radiotherapy. Lastly, we present preliminary dose estimates for 223 Ra in humans. Results indicate that repeated dosing is feasible and toxicity is low, and that opportunities are available for combined treatment strategies.

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Section: Radiotherapymentioning

confidence: 99%

High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the α-Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities?

Bruland

Nilsson²,

Fisher

et al. 2006

Clinical Cancer Research

314

224

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“…QoL indices were evaluated using cancer linear analog scales, for well-being (CLAS1), fatigue (CLAS2) and ability to perform daily activities (CLAS3), respectively (23). The visual analog scale (VAS) for pain (24), the pain score (pain evaluation obtained by multiplying severity x frequency) and the drugs score (analgesic assumption evaluation obtained by multiplying severity x frequency) were used to record and monitor pain (25).…”

Section: Methodsmentioning

confidence: 99%

Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results

et al. 2014

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Abstract. In the present study, the preliminary results of the first stereotactic body radiosurgery (SRS) experience with volumetric intensity modulated arc therapy (VMAT) in oligometastatic breast and recurrent gynecological tumors (OBRGT) are reported in terms of feasibility, toxicity and efficacy. Patients were treated in a head-first supine treatment position on a customized body frame immobilization shell. SRS-VMAT treatment plans were optimized using the ERGO++ treatment planning system. Response assessment was performed 8-12 weeks after treatment by morphologic imaging modalities, or if feasible, also by functional imaging. Thirty-six lesions in 24 consecutive patients (median age, 63 years; range, 40-81) were treated: 13.9% had primary or metastatic lung lesions, 30.5% had liver metastases, 36.1% had bone lesions, 16.7% had lymph node metastases and 2.8% had a primary vulvar melanoma. The median dose was 18 Gy (BED 2 Gy, α/β: 10 =50.4 Gy), the minimal dose was 12 Gy (BED 2 Gy, α/β: 10 =26.4 Gy) and the maximal dose was 28 Gy (BED 2 Gy, α/β: 10 =106.4 Gy). Seven patients (29.2%) experienced acute toxicity, which however was grade 2 in only 1 case. Moreover, only 3 patients (12.5%) developed late toxicity of which only 1 was grade 2. Objective response rate was 77.7% including 16 lesions achieving complete response (44.4%) and 12 lesions achieving partial response (33.3%). The median duration of follow-up was 15.5 months (range, 6-50). Recurrence/progression within the SRS-VMAT treated field was observed in 6 patients (total lesions=7) with a 2-year inside SRS-VMAT field disease control expressed on a per lesion basis of 69%. Recurrence/progression of disease outside the SRS-VMAT field was documented in 15 patients; the 2-year outside SRS-VMAT field metastasis-free survival, expressed on a per patient basis, was 35%. Death due to disease was documented in 6 patients and the 2-year overall survival was 58%. Although the maximum tolerated dose was not reached, SRS-VMAT resulted in positive early clinical results in terms of tumor response, local control rate and toxicity.

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“…Patients scored their perceptions of these symptoms by placing a mark on a 100-mm line to indicate magnitude of the symptom (21). The visual analog scale (VAS) for pain, the Pain score (pain evaluation obtained by multiplying severity x frequency) and the Drugs score (analgesic assumption evaluation obtained by multiplying severity x frequency) were used to record and monitor pain (22). The weight and ECOG score of patients before and after (3-4 weeks) ESRT were recorded by nursing staff.…”

Section: Methodsmentioning

confidence: 99%

Stereotactic radiotherapy in recurrent gynecological cancer: A case series

Deodato¹,

Macchia

Grimaldi

et al. 2009

Oncol Rep

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Abstract. Scarce data are available on the use of extracranial stereotactic radiotherapy in recurrent gynecological tumors. The aim of this report was to analyze the results of our preliminary experience with extracranial stereotactic radiotherapy in locally or distantly recurrent gynecological tumors. Extracranial stereotactic radiotherapy was planned by the Precise-Plan treatment planning system. Patients were immobilized using the Stereotactic Body-Frame. Five consecutive daily fractions were delivered; dose/ fraction and total dose were defined based on an institutional doseescalation protocol. A class solution with 4 non-coplanar fixed beams based on the tetrad configuration was used in all patients. Eleven patients (12 lesions), were included in the analysis. Stereotactic radiotherapy was delivered as first radiotherapy treatment (5 patients), or as retreatment (6 patients).Complete clinical response was achieved in 8/12 lesions (66.6%), while partial response was documented in 2/12 lesions (16.6%). With a median follow-up of 19 months (range, 2-37 months), 7 patients (63%) experienced local and/or distant progression of disease. The 2-year local progression-free survival was 81.8%, while the 2-year metastases-free survival was 54.4%. The 2-year overall survival was 63.6%. Acute and late toxicities were grade 2 or less. There was no difference in quality of life scores between the data collected before extracranial stereotactic radiotherapy and at first follow-up evaluation. Fractionated extracranial stereotactic radiotherapy administered up to a dose of 30 Gy in five fractions is well tolerated. Further studies of extracranial stereotactic radiotherapy and novel radiotherapy techniques are warranted in the challenging setting of recurrent gynecological tumors.

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Fractionated half-body irradiation (HBI) for the rapid palliation of widespread, symptomatic, metastatic bone disease: a randomized Phase III trial of the International Atomic Energy Agency (IAEA)

Cited by 17 publications

References 2 publications

High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the α-Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities?

High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the α-Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities?

Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results

Stereotactic radiotherapy in recurrent gynecological cancer: A case series

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