Stereotactic Body Radiotherapy for Spinal and Bone Metastases

Bhattacharya, Indrani; Hoskin, Peter

doi:10.1016/j.clon.2015.01.030

Cited by 68 publications

(46 citation statements)

References 58 publications

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“…Efficacy and safety data for SBRT are mostly from retrospective single-institution analysis. Generally pain relief and local tumor control were recorded in over 80% of metastatic patients, with an extremely low (less than 0.5%) incidence of myelopathy [32]. …”

Section: Radiation Therapy Techniquesmentioning

confidence: 99%

The role of radiation therapy in bone metastases management

et al. 2017

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Section: Radiation Therapy Techniquesmentioning

confidence: 99%

The role of radiation therapy in bone metastases management

et al. 2017

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“…Stereotactic body radiotherapy (SBRT) for bone metastases tries to improve the pain response by increasing the dose to the bone metastases with promising safety and efficacy as reported in non-randomized studies [5,6,26,28,33]. Pain relief is seen in over 80% of the patients treated with SBRT.…”

mentioning

confidence: 98%

Biological 18[F]-FDG-PET image-guided dose painting by numbers for painful uncomplicated bone metastases: A 3-arm randomized phase II trial

Berwouts¹,

Wolf²,

Lambert³

et al. 2015

Radiotherapy and Oncology

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“…Precise confinement of the radiation dose, even including dose escalation in addition, should increase the probability of pain relief while the risk of injury to the spinal cord is minimized. Several retrospective and prospective phase II studies have indeed shown the safety and efficacy of SBRT in spinal metastases [5, 6]. …”

Section: Discussionmentioning

confidence: 99%

“…Stereotactic body radiotherapy (SBRT) is able to deliver precise high-dose radiation to spinal metastases in single or multiple fractions, while sparing surrounding healthy tissues. Phase I and II studies have suggested that, for selected groups of patients, SBRT for spinal metastases may be accurate, safe, and effective [5, 6], with complete pain response in 54% of patients six months after SBRT [7]. Other authors even reported overall pain response rates around 90% [8–10].…”

Section: Introductionmentioning

confidence: 99%

Comparing conVEntional RadioTherapy with stereotactIC body radiotherapy in patients with spinAL metastases: study protocol for an randomized controlled trial following the cohort multiple randomized controlled trial design

et al. 2016

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BackgroundStandard radiotherapy is the treatment of first choice in patients with symptomatic spinal metastases, but is only moderately effective. Stereotactic body radiation therapy is increasingly used to treat spinal metastases, without randomized evidence of superiority over standard radiotherapy. The VERTICAL study aims to quantify the effect of stereotactic radiation therapy in patients with metastatic spinal disease.Methods/designThis study follows the ‘cohort multiple Randomized Controlled Trial’ design. The VERTICAL study is conducted within the PRESENT cohort. In PRESENT, all patients with bone metastases referred for radiation therapy are enrolled. For each patient, clinical and patient-reported outcomes are captured at baseline and at regular intervals during follow-up. In addition, patients give informed consent to be offered experimental interventions. Within PRESENT, 110 patients are identified as a sub cohort of eligible patients (i.e. patients with unirradiated painful, mechanically stable spinal metastases who are able to undergo stereotactic radiation therapy). After a protocol amendment, also patients with non-spinal bony metastases are eligible. From the sub cohort, a random selection of patients is offered stereotactic radiation therapy (n = 55), which patients may accept or refuse. Only patients accepting stereotactic radiation therapy sign informed consent for the VERTICAL trial. Non-selected patients (n = 55) receive standard radiotherapy, and are not aware of them serving as controls. Primary endpoint is pain response after three months. Data will be analyzed by intention to treat, complemented by instrumental variable analysis in case of substantial refusal of the stereotactic radiation therapy in the intervention arm.DiscussionThis study is designed to quantify the treatment response after (stereotactic) radiation therapy in patients with symptomatic spinal metastases. This is the first randomized study in palliative care following the cohort multiple Randomized Controlled Trial design. This design addresses common difficulties associated with classic pragmatic randomized controlled trials, such as disappointment bias in patients allocated to the control arm, slow recruitment, and poor generalizability.Trial registrationThe Netherlands Trials Register number NL49316.041.14. ClinicalTrials.gov registration number NCT02364115. Date of trial registration February 1, 2015.

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Stereotactic Body Radiotherapy for Spinal and Bone Metastases

Cited by 68 publications

References 58 publications

The role of radiation therapy in bone metastases management

The role of radiation therapy in bone metastases management

Biological 18[F]-FDG-PET image-guided dose painting by numbers for painful uncomplicated bone metastases: A 3-arm randomized phase II trial

Comparing conVEntional RadioTherapy with stereotactIC body radiotherapy in patients with spinAL metastases: study protocol for an randomized controlled trial following the cohort multiple randomized controlled trial design

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