Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases

Okawa, Tomohiko; Kita, Midori; Goto, Makiko; Nishijima, Hiroshi; Miyaji, Noriaki

doi:10.1016/0167-8140(88)90031-x

Cited by 90 publications

(19 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sin gle shot radiotherapy is the most extreme possibility. Three prospective randomized trials from Denmark [4], Japan [6] and authors drew the same conclusions [7]; in the latter study response rates and also response duration in a subgroup (51 of 288 patients) have been reported. However, none of these studies included the degree of remineralisation.…”

Section: Discussionmentioning

confidence: 71%

“…Regard ing the influence of histology, pain control in bone métastasés from breast cancer is superior when compared with other tumors. Other groups [6,7] reported no correlation between different tumors in response to irradiation; Nielsen et al [5] concluded from their review that this question never had been properly addressed. Currently in our institution, radiotherapeutic fractionation is chosen more and more indi vidualised.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pain Management Policy: Comparison of Two Irradiation Schedules in Metastatic Bone Pain

Karstens¹,

Blach²,

Ammon³

1991

Oncol Res Treat

View full text Add to dashboard Cite

Bone metastases present a frequent problem in oncology. Although fractionated irradiation with 10–15 (20) fractions is the best mode of radiotherapy, low-dose short-term irradiation schedules are of interest as they will reduce inconveniences like transportation problems. In two consecutive prospective follow-up studies patients with painful non-vertebral bone metastases were irradiated with a single shot (4 Gy) treatment or four fractions with 4 Gy. Response rates and duration of response are significantly better with the 4×4 Gy schedule. From these data and recently published data a more individualised pain management is proposed.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Pain Management Policy: Comparison of Two Irradiation Schedules in Metastatic Bone Pain

Karstens¹,

Blach²,

Ammon³

1991

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…Tong et al [27] described earlier onset of pain relief after radiotherapy completed in 1 week as com- pared to radiotherapy completed in 3 weeks. Okawa et al [18] reported pain relief within 13 ± 9 days after fractionated treatment with total doses up to 17 ± 6 Gy administered in about 4 days. When lower daily doses were used, a larger total dose was needed and the onset of pain relief started later.…”

Section: Onset Of Pain Reliefmentioning

confidence: 99%

“…A variety of fractionation schemes is used. Generally total doses in the range of 20 to 40 Gy over a period of 2 to 4 weeks are applied (e. g. [3,18,23]). To reduce the burden to patients there is a continuous interest to administer only 1 or a few dose fractions for inducing pain relief.…”

mentioning

confidence: 99%

Single-Dose Radiotherapy for Painful Bone Metastases

Kal¹

1999

Strahlenther Onkol

View full text Add to dashboard Cite

show abstract

“…Since the RTOG trial [34] there have been several trials evaluating dose fractionation schemes [34,35] with no schedule or dose demonstrating significantly better outcome. Single-fraction radiotherapy has been advocated as a cost effective way to palliate bony metastases.…”

Section: Radiotherapymentioning

confidence: 99%

Orthopaedic perspective on bone metastasis

Molloy

O’Toole²

2013

WJO

View full text Add to dashboard Cite

The incidence of cancer is increasing worldwide, with the advent of a myriad of new treatment options, so is the overall survival of these patients. However, from an orthopaedic perspective, there comes the challenge of treating more patients with a variety of metastatic bone lesions. The consequences of such lesions can be significant to the patient, from pain and abnormal blood results, including hypercalcemia, to pathological fracture. Given the multiple options available, the treatment of bone metastasis should be based on a patientby patient manner, as is the case with primary bone lesions. It is imperative, given the various lesion types and locations, treatment of bone metastasis should be performed in an individualised manner. We should consider the nature of the lesion, the effect of treatment on the patient and the overall outcome of our decisions. The dissemination of primary lesions to distant sites is a complex pathway involving numerous cytokines within the tumour itself and the surrounding microenvironment. To date, it is not fully understood and we still base a large section of our knowledge on Pagets historic "seed and soil" theory. As we gain further understanding of this pathway it will allow us develop more medical based treatments. The treatment of primary cancers has long been provided in a multi-disciplinary setting to achieve the best patient outcomes. This should also be true for the treatment of bone metastases. Orthopaedic surgeons should be involved in the multidisciplinary treatment of such patients given that there are a variety of both surgical fixation methods and non-operative methods at our disposal. MINIREVIEWS© 2013 Baishideng. All rights reserved.Key words: Bone metastases; Diagnosis; Pathophysiology; Surgical treatment, Medical treatment Core tip: This paper discusses the pathophysiology and patient implications of bone metastasis. We aim to describe the orthopaedic input into the management of this condition, especially in a multi-disciplinary setting. We believe that orthopaedics do not have a significant enough involvement in the treatment of long bone metastasis, although from this paper we feel we have many options to offer. The future of metastasis treatment may be targeted at the molecular level but current management options do require an understanding of musculoskeletal oncology to obtain best patient outcomes through operative and non-operative means.Molloy AP, O'Toole GC. Orthopaedic perspective on bone metastasis. World

show abstract

Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases

Cited by 90 publications

References 13 publications

Pain Management Policy: Comparison of Two Irradiation Schedules in Metastatic Bone Pain

Pain Management Policy: Comparison of Two Irradiation Schedules in Metastatic Bone Pain

Single-Dose Radiotherapy for Painful Bone Metastases

Orthopaedic perspective on bone metastasis

Contact Info

Product

Resources

About