Multifraction radiotherapy for palliation of painful bone metastases: 20 Gy versus 30 Gy

Maurizio Valeriani, Claudia Scaringi, Luciana Blasi, Alessia Carnevale, Vitaliana De Sanctis, Paolo Bonome, Stefano Bracci, Gianluca Marrone, Giuseppe Minniti, Riccardo Maurizi Enrici

Research output: Contribution to journalArticle

Abstract

Aims and Background: To compare 2 multifraction radiotherapy schedules in the palliation of painful bone metastases. Methods and Study design: We retrospectively analyzed clinical data of 105 patients with a total of 140 painful bone metastases who were treated with 20 Gy in 5 fractions or 30 Gy in 10 fractions. The primary tumors were breast (30%), lung (28%), and prostate (14%). The main sites of irradiation were spine (n = 79) and sacrum or pelvis (n = 39). Pain was graded by patients according to the pain numeric rating scale just before and 1 month after radiotherapy. Pain progression was defined as an increase .2 on pain scale after an initial response. Results: The overall response rate at 1 month was 88.6%. Overall response rate was 89.6% in the 20-Gy arm and 87.3% in the 30-Gy arm (p = 0.669). The rate of complete response was statistically better in patients treated with 30 Gy (p = 0.019). The mean reduction in pain was 3.2 in the 20-Gy group and 3.6 in the 30-Gy group. Pain progression was 6.5% and 1.6%, respectively. The incidence of acute toxicity was statistically significantly higher in the 30-Gy arm (23.8%) than in the 20-Gy arm (2.6%) (p = 0.001). One pathologic fracture of the irradiated bone was observed in the 30-Gy arm. Two lesions, one in each group, were re-irradiated for pain recurrence. Pain progression was found in 6.5% of the irradiated lesions in the 20-Gy arm and in 1.6% in the 30-Gy arm. Conclusions: In our series, both regimens achieved high rate of pain relief, although the group treated with higher total dose reported better complete response rate. The 30-Gy arm had a significantly higher rate of acute toxicity.

Original languageEnglish
Pages (from-to)318-322
Number of pages5
JournalTumori
Volume101
Issue number3
DOIs
Publication statusPublished - May 1 2015

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Radiotherapy
Arm
Neoplasm Metastasis
Bone and Bones
Pain
Sacrum
Spontaneous Fractures
Pelvis
Prostate
Appointments and Schedules
Spine
Breast Neoplasms
Recurrence
Lung
Incidence

Keywords

  • Bone metastases
  • Multifraction radiotherapy
  • Palliation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Valeriani, M., Scaringi, C., Blasi, L., Carnevale, A., De Sanctis, V., Bonome, P., ... Enrici, R. M. (2015). Multifraction radiotherapy for palliation of painful bone metastases: 20 Gy versus 30 Gy. Tumori, 101(3), 318-322. https://doi.org/10.5301/tj.5000286

Multifraction radiotherapy for palliation of painful bone metastases : 20 Gy versus 30 Gy. / Valeriani, Maurizio; Scaringi, Claudia; Blasi, Luciana; Carnevale, Alessia; De Sanctis, Vitaliana; Bonome, Paolo; Bracci, Stefano; Marrone, Gianluca; Minniti, Giuseppe; Enrici, Riccardo Maurizi.

In: Tumori, Vol. 101, No. 3, 01.05.2015, p. 318-322.

Research output: Contribution to journalArticle

Valeriani, M, Scaringi, C, Blasi, L, Carnevale, A, De Sanctis, V, Bonome, P, Bracci, S, Marrone, G, Minniti, G & Enrici, RM 2015, 'Multifraction radiotherapy for palliation of painful bone metastases: 20 Gy versus 30 Gy', Tumori, vol. 101, no. 3, pp. 318-322. https://doi.org/10.5301/tj.5000286
Valeriani M, Scaringi C, Blasi L, Carnevale A, De Sanctis V, Bonome P et al. Multifraction radiotherapy for palliation of painful bone metastases: 20 Gy versus 30 Gy. Tumori. 2015 May 1;101(3):318-322. https://doi.org/10.5301/tj.5000286
Valeriani, Maurizio ; Scaringi, Claudia ; Blasi, Luciana ; Carnevale, Alessia ; De Sanctis, Vitaliana ; Bonome, Paolo ; Bracci, Stefano ; Marrone, Gianluca ; Minniti, Giuseppe ; Enrici, Riccardo Maurizi. / Multifraction radiotherapy for palliation of painful bone metastases : 20 Gy versus 30 Gy. In: Tumori. 2015 ; Vol. 101, No. 3. pp. 318-322.
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abstract = "Aims and Background: To compare 2 multifraction radiotherapy schedules in the palliation of painful bone metastases. Methods and Study design: We retrospectively analyzed clinical data of 105 patients with a total of 140 painful bone metastases who were treated with 20 Gy in 5 fractions or 30 Gy in 10 fractions. The primary tumors were breast (30{\%}), lung (28{\%}), and prostate (14{\%}). The main sites of irradiation were spine (n = 79) and sacrum or pelvis (n = 39). Pain was graded by patients according to the pain numeric rating scale just before and 1 month after radiotherapy. Pain progression was defined as an increase .2 on pain scale after an initial response. Results: The overall response rate at 1 month was 88.6{\%}. Overall response rate was 89.6{\%} in the 20-Gy arm and 87.3{\%} in the 30-Gy arm (p = 0.669). The rate of complete response was statistically better in patients treated with 30 Gy (p = 0.019). The mean reduction in pain was 3.2 in the 20-Gy group and 3.6 in the 30-Gy group. Pain progression was 6.5{\%} and 1.6{\%}, respectively. The incidence of acute toxicity was statistically significantly higher in the 30-Gy arm (23.8{\%}) than in the 20-Gy arm (2.6{\%}) (p = 0.001). One pathologic fracture of the irradiated bone was observed in the 30-Gy arm. Two lesions, one in each group, were re-irradiated for pain recurrence. Pain progression was found in 6.5{\%} of the irradiated lesions in the 20-Gy arm and in 1.6{\%} in the 30-Gy arm. Conclusions: In our series, both regimens achieved high rate of pain relief, although the group treated with higher total dose reported better complete response rate. The 30-Gy arm had a significantly higher rate of acute toxicity.",
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AU - Valeriani, Maurizio

AU - Scaringi, Claudia

AU - Blasi, Luciana

AU - Carnevale, Alessia

AU - De Sanctis, Vitaliana

AU - Bonome, Paolo

AU - Bracci, Stefano

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AB - Aims and Background: To compare 2 multifraction radiotherapy schedules in the palliation of painful bone metastases. Methods and Study design: We retrospectively analyzed clinical data of 105 patients with a total of 140 painful bone metastases who were treated with 20 Gy in 5 fractions or 30 Gy in 10 fractions. The primary tumors were breast (30%), lung (28%), and prostate (14%). The main sites of irradiation were spine (n = 79) and sacrum or pelvis (n = 39). Pain was graded by patients according to the pain numeric rating scale just before and 1 month after radiotherapy. Pain progression was defined as an increase .2 on pain scale after an initial response. Results: The overall response rate at 1 month was 88.6%. Overall response rate was 89.6% in the 20-Gy arm and 87.3% in the 30-Gy arm (p = 0.669). The rate of complete response was statistically better in patients treated with 30 Gy (p = 0.019). The mean reduction in pain was 3.2 in the 20-Gy group and 3.6 in the 30-Gy group. Pain progression was 6.5% and 1.6%, respectively. The incidence of acute toxicity was statistically significantly higher in the 30-Gy arm (23.8%) than in the 20-Gy arm (2.6%) (p = 0.001). One pathologic fracture of the irradiated bone was observed in the 30-Gy arm. Two lesions, one in each group, were re-irradiated for pain recurrence. Pain progression was found in 6.5% of the irradiated lesions in the 20-Gy arm and in 1.6% in the 30-Gy arm. Conclusions: In our series, both regimens achieved high rate of pain relief, although the group treated with higher total dose reported better complete response rate. The 30-Gy arm had a significantly higher rate of acute toxicity.

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