Randomized trial of single dose versus fractionated palliative radiotherapy of bone metastases

Nielsen, Ole Steen; Bentzen, Søren M.; Sandberg, Erik; Gadeberg, C.; Timothy, A.R.

doi:10.1016/s0167-8140(98)00011-5

Cited by 277 publications

(123 citation statements)

References 21 publications

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“…The indirect nature of the mechanism is suggested by the gradual onset and improvement in pain relief (one to four weeks) after initiating palliative radiation. 100,101,110,111 A shared mechanism is also suggested by the activity of corticosteroids, which not only relieve pain but are used to prevent delayed chemotherapy-induced nausea and emesis. 112 On the other hand, opioids to relieve pain, as well as metabolic abnormalities such as hypercalcemia, result in nausea and vomiting by activating the chemoreceptive trigger zone.…”

Section: Future Research On Crossover Interventionsmentioning

confidence: 99%

The Relationship of Cancer Symptom Clusters to Depressive Affect in the Initial Phase of Palliative Radiation

Francoeur

2005

Journal of Pain and Symptom Management

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Research on comorbidity across cancer symptoms, including pain, fatigue, and depression, could suggest if crossover effects from symptom-specific interventions are plausible. Secondary analyses were conducted on a survey of 268 cancer patients with recurrent disease from a northeastern U.S. city who were initiating palliative radiation for bone pain. Moderator regression analyses predicted variation in depressive affect that could be attributed to symptom clusters. Patients self-reported difficulty controlling each physical symptom over the past month on a Likert scale and depressive symptoms on a validated depression measure (Center for Epidemiologic Studies-Depression [CES-D]) over the past week on a four-category scale. An index of depressive affect was based on items of negative and positive affect from the CES-D. In predicting depressive affect, synergistic interactions of pain with fever, fatigue, and weight loss suggest separate pathways involving pain. A similar interaction with fever occurs when nausea was tested in place of pain. Further, the interaction between pain and fatigue is similar in form to the interaction between difficulty breathing and fatigue (when sleep is not a problem). Follow-up to the latter interaction reveals: 1) additional moderation by hypertension and palliative radiation to the hip/pelvis; and 2) a similar cluster not involving hypertension when appetite problems and weight loss were tested in place of fatigue. The significance and form of these interactions are remarkably consistent. Similar sickness mechanisms could be generating: 1) pain and nausea during fever; 2) pain and fatigue during weight loss; and 3) pain and breathing difficulty when fatigue is pronounced. Crossover effects from symptom-specific interventions appear promising.

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Section: Future Research On Crossover Interventionsmentioning

confidence: 99%

The Relationship of Cancer Symptom Clusters to Depressive Affect in the Initial Phase of Palliative Radiation

Francoeur

2005

Journal of Pain and Symptom Management

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“…Although the efficacy and safety of radiotherapy using a single direct field for spinal bone metastases have been proven through numerous clinical trials for both single-and multi-fraction radiotherapy [7][8][9][10][11][12][13][14][15], a large number of respondents stated that they never use a single direct field for spinal bone metastases. Those who never use a single direct field may prefer to use parallel opposing fields or highly conformal radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Variability in the Point to Which Single Direct Field Irradiation is Prescribed for Spinal Bone Metastases: A Survey of Practice Patterns in Japan

Nakamura¹,

Shikama

Wada³

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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Direct single fields are commonly used in radiotherapy for spinal bone metastases, and it is crucial to define the point for which the dose is prescribed. According to the guidelines from the International Bone Metastases Consensus Working Party (IBMCWP) updated in 2010, different opinions exist on whether this therapy should be prescribed to the mid-vertebral or anterior vertebral body. To our knowledge, no previous studies have surveyed practice patterns regarding this discrepancy. Therefore, we performed an Internet-based survey of members of the Japanese Radiation Oncology Study Group (JROSG) to investigate the current practice patterns in Japan. The respondents mentioned the point to which they prescribed radiotherapy for a single direct field. A total of 52 radiation oncologists from 50 institutions (36% of JROSG institutions) responded. Respondent prescription for radiotherapy varied widely. Only 21% and 6% of respondents prescribed irradiation to the mid-vertebral body and anterior vertebral body, respectively. A larger proportion of respondents (27%) prescribed irradiation to the spinal cord (center of the spinal canal). Still another group of respondents (27%) stated that they never use a single direct field. In conclusion, the point to which irradiation dosages are prescribed varies widely for a single direct field in cases of spinal bone metastases. This variation may lead some radiation oncologists to misunderstand the tolerance dosage of the spinal cord, especially in cases of reirradiation. Thus, careful consideration is required before any prescriptions are made.

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“…Likewise, acute toxicity and quality of life are generally similar, although increased acute toxicity with multifraction treatments has been reported [Price et al 1986;Gaze et al 1997;Jeremic et al 1998;Nielsen et al 1998;Bone Pain Trial Working Party, 1999;Steenland et al 1999;Hartsell et al 2005]. These data indicate that excellent palliation of bone metastases can be achieved with single-fraction EBRT.…”

Section: Localized External Beam Radiotherapy For Bone Metastasesmentioning

confidence: 94%

The role of radiation therapy in the treatment of metastatic castrate-resistant prostate cancer

Rose

Crook

2015

Therapeutic Advances in Urology

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Randomized trial of single dose versus fractionated palliative radiotherapy of bone metastases

Cited by 277 publications

References 21 publications

The Relationship of Cancer Symptom Clusters to Depressive Affect in the Initial Phase of Palliative Radiation

The Relationship of Cancer Symptom Clusters to Depressive Affect in the Initial Phase of Palliative Radiation

Variability in the Point to Which Single Direct Field Irradiation is Prescribed for Spinal Bone Metastases: A Survey of Practice Patterns in Japan

The role of radiation therapy in the treatment of metastatic castrate-resistant prostate cancer

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