Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases

Chow, Edward; Hoskin, Peter; Mitera, Gunita; Zeng, Liang; Lutz, S; Roos, Daniel; Hahn, Carol A.; Linden, Yvette M. van der; Hartsell, William F.; Kumar, Eshwar

doi:10.1016/j.ijrobp.2011.02.008

Cited by 295 publications

(266 citation statements)

References 25 publications

Supporting

Mentioning

261

Contrasting

Unclassified

Order By: Relevance

“…Pain response was calculated by taking changes in pain score and pain medication into account, according to international criteria [32]. No fixed time interval from the date of randomization was applied.…”

Section: Pain Responsementioning

confidence: 99%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

View full text Add to dashboard Cite

Background: Psychological distress (PD) has a major impact on quality of life. We studied the incidence of PD before and after radiotherapy for painful bone metastases. Furthermore, we aimed to identify factors predictive for PD. Methods: Between 1996 and 1998, the Dutch Bone Metastasis Study included 1157 patients with painful bone metastases. Patients were randomized between two fractionation schedules. The study showed a pain response of 74% in both groups. Patients filled out weekly questionnaires for 13 weeks, then monthly for two years. The questionnaires included a subscale for PD on the Rotterdam Symptom Checklist. We used generalized estimating equations and multivariable logistic regression analyses. Results: At baseline, 290 patients (27%) had a high level of PD. For the entire group, the level of PD remained constant over time. The majority of patients with a low level of PD at baseline remained at a low level during follow-up. In patients with a high level of PD at baseline, the mean level of PD decreased after treatment and stabilized around the cutoff level. Female patients, higher age, worse performance, lower pain score and worse self-reported QoL were associated with an increased chance of PD, although the model showed moderate discriminative power. Conclusions: A substantial proportion of patients had a high level of PD before and after radiotherapy for painful bone metastases. Most patients who reported high levels of PD when referred for palliative radiotherapy remained at high levels thereafter. Therefore, screening of PD prior to treatment seems appropriate, in order to select patients requiring intervention.

show abstract

Section: Pain Responsementioning

confidence: 99%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Conventional two-dimensional (2D) RT techniques for spine metastases utilize a single posteroanterior (PA) field or anteroposterior/posteroanterior (AP/PA) parallel-opposed fields for thoracic-lumbar-sacral spines or parallel-opposed lateral fields for cervical spines (3). These methods are simple and may be readily practiced; however, these methods do not spare adjacent healthy organs from the harmful effects of irradiation.…”

Section: Introductionmentioning

confidence: 99%

Palliative radiotherapy for thoracic spine metastases: Dosimetric advantage of three-dimensional conformal plans

Yeo¹

2015

Oncology Letters

View full text Add to dashboard Cite

Abstract. The aim of the present study was to investigate the dosimetric advantages of three-dimensional conformal radiation therapy (3DCRT) for thoracic spine metastases and compare it with conventional two-dimensional (2D) plans. Radiation therapy (RT) planning data of 10 patients with mid-to-low thoracic spine metastases were analyzed. Computed tomography simulation was performed and the planning target volume (PTV), heart, esophagus, lung and spinal cord were contoured. The 3DCRT plan comprised one posteroanterior (PA) field and two posterior oblique fields. The 2D plans used a single PA field or opposed anteroposterior (AP)/PA fields. The prescription dose of radiation was 30 Gy in 10 fractions. All comparisons of the maximum or mean doses to the organs at risk or the PTV, between two of the three RT plans, demonstrated statistically significant differences (P<0.05), with the exception of the mean esophageal doses between the single PA vs. AP/PA (P=0.285) plans. The mean heart doses were 15.0±3.1 Gy in single PA, 17.3±4.3 Gy in AP/PA and 8.5±1.7 Gy using 3DCRT. The median reduction rates using 3DCRT were 38.9% compared with single PA (range, 29.4-58.5%) or 47.5% relative to AP/PA (range, 34.5-67.1%). The mean esophageal doses were 17.9±2.3 Gy in single PA, 18.2±2.2 Gy in AP/PA and 15.3±1.9 Gy in 3DCRT. The median reduction rate using 3DCRT was 12.8% compared with single PA or 15.6% relative to AP/PA. Compared with the single PA or AP/PA 2D plan, 3DCRT reduced the median dose by 13.7 or 1.9% of the maximum spinal cord dose, respectively, and 14.7 or 2.9% of the maximum PTV dose, respectively. The mean lung doses were 2.7±0.7 Gy in single PA, 2.6±0.7 Gy in AP/PA and 5.1±1.0 Gy in 3DCRT. In conclusion, 3DCRT for mid-to-low thoracic spine metastases demonstrated significant dosimetric advantages by reducing the unnecessary irradiation of critical organs, particularly the heart, and by achieving a homogeneous target dose.

show abstract

“…According to the guideline from the IBMCWP, updated in 2010, opinion was split between prescribing to the midvertebral body or anterior vertebral body [3]. However, only 21 and 6% of respondents prescribed irradiation to the midvertebral body and anterior vertebral body, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Variations of the point cause changes in doses for the tumor and organs at risk, particularly for the spinal cord, which may lead to variations in the efficacy and safety of radiotherapy for spinal bone metastases [2]. 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 midvertebral or anterior vertebral body [3]. However, to our knowledge, no previous studies have surveyed practice patterns regarding this discrepancy.…”

Section: Introductionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases

Cited by 295 publications

References 25 publications

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

Palliative radiotherapy for thoracic spine metastases: Dosimetric advantage of three-dimensional conformal plans

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

Contact Info

Product

Resources

About