Single fraction radiotherapy is efficacious: A further analysis of the dutch bone metastasis study controlling for the influence of retreatment

被引:214
作者
van der Linden, YM
Lok, JJ
Steenland, E
Martijn, H
van Houwelingen, H
Marijnen, CAM
Leer, JWH
机构
[1] Leiden Univ, Med Ctr, Dept Clin Oncol, NL-2300 RC Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Med Stat, NL-2300 RC Leiden, Netherlands
[3] Catharina Hosp, Dept Radiotherapy, Eindhoven, Netherlands
[4] St Radboud Univ Med Ctr, Dept Radiotherapy, Nijmegen, Netherlands
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2004年 / 59卷 / 02期
关键词
bone metastases; pain; radiotherapy; retreatment; response;
D O I
10.1016/j.ijrobp.2003.10.006
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The Dutch Bone Metastasis Study on the effect on painful bone metastases of 8 Gy single fraction (SF) vs. 24 Gy in multiple fractions (MF) showed 24% retreatment after SF vs. 6% after MF (p < 0.001). The purpose of the present study was to evaluate factors influencing retreatment and its effect on response. Methods and Materials: The database on all randomized patients was reanalyzed with separately calculated responses to initial treatment and retreatment. Results: Response to initial treatment was 71% after SF vs. 73% after MF (p = 0.84). Retreatment raised response to 75% for SF; MF remained unaltered (p = 0.54). The response status after initial treatment did not predict occurrence of retreatment: 35% SF vs. 8% MF nonresponders and 22% SF vs. 10% MF patients with progressive pain were retreated. Logistic regression analyses showed the randomization arm and the pain score before retreatment to significantly predict retreatment (p < 0.001). Retreatment for nonresponders was successful in 66% SF vs. 33% MF patients (p = 0.13). Retreatment for progression was successful in 70% SF vs. 57% MF patients (p = 0.24). Conclusions: With or without the effect of retreatment, SF and MF radiotherapy provided equal palliation for painful bone metastases. Irrespective of response to initial treatment, physicians were more willing to retreat after a single fraction. Overall, retreatment was effective in 63% of retreated patients. (C) 2004 Elsevier Inc.
引用
收藏
页码:528 / 537
页数:10
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