Long-term follow-up of cancer patients receiving radiotherapy for bone metastases: Results from a randomised multicentre trial

Sande, Tonje A.; Ruenes, Randi; Lund, Jo Åsmund; Bruland, Øyvind S.; Hornslien, Kjersti; Bremnes, Roy M.; Kaasa, Stein

doi:10.1016/j.radonc.2009.02.014

Cited by 50 publications

(34 citation statements)

References 11 publications

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“…The median durations of overall pain relief for MFs were 3.8 and 1.8 mo after SF treatment. These results were similar to those reported for other series involving different primary cancers [24,25,34] . In our study, we found that EBRT effectively palliated painful BMs from HCC, that an 8 Gy SF and MFs resulted in equivalent pain relief, and that high-dose MF schedules may result in longer lasting pain relief.…”

Section: Radiotherapy For Bone Painsupporting

confidence: 92%

“…Similar findings concerning the pain relief after treatment based on an SF or MFs have also been reported [26,34] . Similarly, according to other recent studies including a meta-analysis, both SF and MF-based treatments have provided equivalent pain relief, although SF treatment often requires re-treatment [23][24][25]35] . In terms of pain relief, most previous studies failed to show a dose-response relationship for BMs from other primary cancers.…”

Section: Radiotherapy For Bone Painmentioning

confidence: 75%

“…Generally, pain relief is obtained in 60%-90% of treated patients, but the sites of primary tumors from these reports were mainly in the lung, breast, and prostate [23][24][25][26] . There have only been a few studies of EBRT for HCC BMs, but they show that 73%-99.5% of patients obtained overall pain improvement and 17%-44% of patients achieved complete pain relief (Table 2) [7,8,[27][28][29][30] .…”

Section: Radiotherapy For Bone Painmentioning

confidence: 99%

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Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Hayashi

Tanaka

Hoshi

2014

WJH

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The incidence of bone metastases (BMs) from hepatocellular carcinoma (HCC) is relatively low compared to those of other cancers, but it has increased recently, especially in Asian countries. Typically, BMs from HCC appear radiologically as osteolytic, destructive, and expansive components with large, bulky soft-tissue masses. These soft-tissue masses are unique to bone metastases from HCC and often replace the normal bone matrix and exhibit expansive growth. They often compress the peripheral nerves, spinal cord, or cranial nerves, causing not only bone pain but also neuropathic pain and neurological symptoms. In patients with spinal BMs, the consequent metastatic spinal cord compression (MSCC) causes paralysis. Skull base metastases (SBMs) with cranial nerve involvement can cause neurological symptoms. Therefore, patients with bony lesions often suffer from pain or neurological symptoms that have a severe, adverse effect on the quality of life. External-beam radiotherapy (EBRT) can effectively relieve bone pain and neurological symptoms caused by BMs. However, EBRT is not yet widely used for the palliative management of BMs from HCC because of the limited number of relevant studies. Furthermore, the optimal dosing schedule remains unclear, despite clinical evidence to support single-fraction radiation schedules for primary cancers. In this review, we outline data describing palliative EBRT for BMs from HCC in the context of (1) bone pain; (2) MSCC; and (3) SBMs.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Hepatocellular carcinoma; Metastasis; Radiotherapy; Palliative therapy; Spinal cord compression; Skull base metastasis Core tip: Due to a lack of clinical data, external-beam radiotherapy (EBRT) for bone metastases (BMs) from hepatocellular carcinoma (HCC) is still not widely used as a palliative therapy component, and the optimal dosing schedule remains unclear. BMs from HCC typically occur as expansive, bulky soft-tissue masses; they exhibit expansive growth that compresses the peripheral nerves, spinal cord, or cranial nerves, causing both bone and neuropathic pain, and neurological symptoms. In this review, we outline the data describing palliative EBRT for BMs from HCC to treat bone pain, spinal compression, and skull base metastases.Hayashi S, Tanaka H, Hoshi H. Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma.

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Section: Radiotherapy For Bone Painsupporting

confidence: 92%

Section: Radiotherapy For Bone Painmentioning

confidence: 75%

Section: Radiotherapy For Bone Painmentioning

confidence: 99%

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Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Hayashi

Tanaka

Hoshi

2014

WJH

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“…Guideline statement Although many of the studies presented in Table 1 did not delineate treatment relief by spinal vs. nonspinal metastases, the Task Force could find no evidence from reviewing the data to suggest that a single 8-Gy fraction provided inferior pain relief compared with a more prolonged RT course in painful spinal sites, although single fractionation has been associated with a 20% incidence of repeat treatment vs. 8% with fractionated RT (7)(8)(9)(10)(11)(12)(13)(14). The set up and prescription points for treatment should follow those outlined by the International Consensus on Palliative Radiotherapy Endpoints for future clinical trials in bone metastases to minimize the risk and allow for consistent reporting of treatment results (17).…”

Section: Resultsmentioning

confidence: 99%

Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline

Lutz

Berk

Chang

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

753

456

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“…The onset of pain relief varies from a few days to 4 weeks, re-irradiation should therefore not be considered sooner than 4 weeks after the initial radiotherapy. In clinical studies, the median duration of pain relief obtained was 3-6 months [40,41,42]. …”

Section: Standard Of Care For Patients With Metastatic Crpc and Bone mentioning

confidence: 99%

Management of Bone Metastases in Patients with Castration-Resistant Prostate Cancer

et al. 2014

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Bone metastases are a very common problem in prostate cancer. They are associated with considerable morbidity, adversely affect quality of life and frequently lead to advanced bone events (so-called skeletal-related events, SREs); SREs include fractures, spinal cord compression and the requirement for bone surgery or bone radiation. The aim of this paper was to evaluate currently available treatment options in the prevention and management of SREs and bone metastases in men with castration-resistant prostate cancer and to outline the importance of interdisciplinary management strategies. It also discusses the diagnostic workup of osseous metastases and practical considerations for the utilization of bone-targeted therapies in accordance with current guidelines to provide a consensus for special and/or difficult clinical situations.

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Long-term follow-up of cancer patients receiving radiotherapy for bone metastases: Results from a randomised multicentre trial

Cited by 50 publications

References 11 publications

Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline

Management of Bone Metastases in Patients with Castration-Resistant Prostate Cancer

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