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2009 | 15 | 1 | 33-45

Article title

External beam radiotherapy for palliation of painful bone metastases: pooled data bioeffect dose response analysis of dose fractionation

Content

Title variants

Languages of publication

EN

Abstracts

EN
Bone metastases develop in up to 70% of newly diagnosed cancer patients and result in immobility, anxiety, and depression, severely diminishing the patients quality of life. Radiotherapy is a frequently used modality for bone metastasis and has been shown to be effective in reducing metastatic bone pain and in some instances, causing tumor shrinkage or growth inhibition. There is controversy surrounding the optimal fractionation schedule and total dose of external beam radiotherapy, despite many randomized trials and overviews addressing the issue. This study was undertaken to apply BED to clinical fractionation data of radiotherapeutic management of bone metastases in order to arrive at optimum BED values for acceptable level of response rate.A computerised literature search was conducted to identify all prospective clinical studies that addressed the issue of fractionation for the treatment of bone metastasis. The results of these studies were pooled together to form the database for the analysis. A total of 4111 number of patients received radiation dose ranging from 4 to 40.5 Gy in 1 to 15 fractions with dose per fraction ranging from 2 to 10 Gy. Single fraction treatments were delivered in 2013 patients and the dose varied from 4 to 10 Gy. Multifraction treatments were delivered in 2098 patients and the dose varied from 15 to 40.5 Gy. The biological effective dose (BED) was evaluated for each fractionation schedule using the linear quadratic model and an α/β value of 10 Gy. Response rate increased significantly beyond a BED value of 14.4 Gy (p < 0.01). Based on our analysis and indications from the literature about higher retreatment and fracture rate of single fraction treatments, minimum BED value of 14.4 Gy is recommended.

Publisher

Year

Volume

15

Issue

1

Pages

33-45

Physical description

Dates

published
1 - 1 - 2009
online
22 - 9 - 2010

Contributors

author
  • Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bangalore, India
author
  • Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, India
author
  • Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, India
author
  • Department of Radiation Oncology, Amrita Institute of Medical Sciences, Cochin, India

References

  • Bone pain trial working party. 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomized comparison with a multifraction schedule over 12 months of patient follow up. Radiother Oncol. 1999; 52: 111-121.
  • Chow E, Danjoux C. Palliation of bone metastases: a survey of patterns of practice among Canadian radiation oncologists. Radiother Oncol. 2000; 56: 305-314.[PubMed][Crossref]
  • Gaze MN, Kelly CG, et al. Pain relief and quality of life following radiotherapy for bone metastases: a randomized trial of two fractionation schedule. Radiother Oncol. 1997; 45: 109-116.[Crossref][PubMed]
  • Hoskin PJ, Price P, et al. A prospective randomized trial of 4 Gy or 8 Gy single dose in the treatment of metastatic bone pain. Radiother Oncol. 1992; 23: 74-78.
  • Hout WB, Linden YM, et al. Single versus multiple fraction radiotherapy in patients with painful bone metastases: Cost utility analysis based on a randomized trial. J Natl Cancer Inst. 2003; 95: 222-229.[Crossref][PubMed]
  • Jeremic B, Shibamato Y, et al. A randomized trial of three single dose radiation therapy regimens in the treatment of metastatic bone pain. Int J Radiat Oncol Biol Phy. 1998; 42: 161-167.[Crossref]
  • Jeremic B. Single fraction External beam radiation therapy in the treatment of localized metastatic bone pain: A review. J Pain Symp Man. 2001; 22: 1048-1058.[Crossref]
  • Josef EB, Shamsa F, et al. Radiotherapeutic management of osseous metastases: A survey of current patterns of care Int J Radiat Oncol Biol Phy. 1998; 40: 915-921.
  • Josef EB, Shamsa F, et al. External beam radiotherapy for painful osseous metastases: pooled data dose response analysis. Int J Radiat Oncol Biol Phy. 1999; 45: 715-719.[Crossref]
  • Koswing S, Budach V. Remineralisation and schmerzlin derung von knochen metastases nach under schiedlich fractionierter strahlentherapie (10 mal 3 Gy vs 1 mal 8 Gy). Strahlenther Onkol. 1999; 175: 500-508.
  • Nielson OS, Bentzen SM, et al. Randomised trial of single dose vs fractionated palliative radiotherapy of bone metastases. Radiother Oncol. 1998; 47: 233-240.[Crossref]
  • Niewald M, Tkocz HJ, et al. Rapid course radiation therapy vs more standard treatment: a randomized trial for bone metastases. Int J Radiat Oncol Biol Phy. 1996; 36: 1085-1089.[Crossref]
  • Price P, Hoskin PJ, et al. Prospective randomized trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases. Radiother Oncol. 1986; 6: 247-255.[Crossref][PubMed]
  • Rasmusson B, Vejborg I, et al. Irradiation of bone metastases in breast cancer patients: a randomized study with 1 year follow-up. Radiother Oncol. 1995; 34: 179-184.[Crossref]
  • Roos DE. Continuing reluctance to use single fractions of radiotherapy for metastatic bone pain: an Australian and New Zealand practice survey and literature review. Radiother Oncol. 2000; 56: 315-322.[PubMed][Crossref]
  • Rose CM, Kagan AR. The final report of the expert panel for the radiation oncology bone metastases work group of the American college of radiology. Int J Radiat Oncol Biol Phy. 1998; 40: 1117-1124.[Crossref]
  • Shakespeare TP, Lu JJ, et al. Patient preference for radiotherapy fractionation schedule in the palliation of painful bone metastases. J Clin Oncol. 2003; 21: 2156-2162.[PubMed][Crossref]
  • Steenland E, Leer J, et al. The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study. Radiother Oncol. 1999; 52: 101-109.[Crossref][PubMed]
  • Sze WM, Shelley MD, et al. Palliation of metastatic bone pain : Single fraction versus multifraction radiotherapy - A systemic review of randomized trials. Clin Oncol. 2003; 15: 345-352.[Crossref]
  • Szumacher E, et al. Treatment of Bone metastases with palliatives radiotherapy; patients treatment preferences. Int J Radiat Oncol Biol Phy. 2005; 61: 1473-1481.[Crossref]
  • Tong D, Gillick L, Hendrickson FR. The palliation of sympatomatic osseous metastases: the result of the radiation therapy oncology group. Cancer. 1982; 50: 893-900.[Crossref]
  • Wu JSY, Wong R. Meta analysis of dose fractionation radiotherapy trials for the palliation of painful bone metastases. Int J Radiat Oncol Biol Phy. 2003; 55: 594-605.[Crossref]
  • Ellis F. Dose time and fractionation. A clinical hypothesis. Clin Radiol. 1969; 20: 1-10.[Crossref][PubMed]
  • Kirk J, Gray WM, Watson ER. Cumulative radiation effect. Part I. Fractionated radiation regimes. Clin Radiol. 1971; 22: 145-155.[Crossref]
  • Kirk J, Gray WM, Watson ER: Cumulative radiation effect. Part II. Continuous radiation therapy : long lived sources. Clin Radiol. 1972; 23: 93-105.[Crossref]
  • Orton CG, Ellis F. A simplification in the use of NSD concept in clinical practice. Brit J Radiol. 1973; 46: 529-537.[Crossref]
  • Orton CG. Time dose factors in brachytherapy. Brit J Radiol. 1974; 47: 603-607.[Crossref]
  • Barendson GW. Dose fractionation, dose rate and isoeffect relationship for normal tissue responses. Int J Rad Oncol Biol Phys. 1982; 8: 1981-1997.[Crossref]
  • Dale RG. The application of the linear quadratic dose effect equation to fractionated and protracted radiotherapy. Brit J Radiol. 1985; 58: 515-528.[Crossref]
  • Dale RG. The application of the linear quadratic model to fractionated radiotherapy when there is incomplete normal tissue recovery between fractions and possible implications for treatments involving multiple fractions per day. Brit J Radiol. 1986; 59: 919-927.[Crossref]
  • Fowler JF. The linear quadratic formula and progress in fractionated radiotherapy. Brit J Radiol. 1985; 62: 679-694.
  • Orton CG, Cohen L. A unified approach to dose effect relationships in radiotherapy I: modified TDF and Linear Quadratic Equations. Int J Radiat Oncol Biol Phy. 1998; 14: 549-556.
  • Orton CG. Recent developments in time dose modeling. Aus Phy Eng Sci Med. 1991; 14: 5-64.
  • Supe SS. Application of linear quadratic model of dose effect relationship to radiotherapy. Ph.D Thesis, Marathwada University; 1993.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_v10013-009-0004-x
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