IAEA randomised trial of optimal single dose radiotherapy in the treatment of painful bone metastases


Por: Hoskin P., Rojas A., Fidarova E., Jalali R., Mena Merino A., Poitevin A., Oucrif S., Abdelwahab S., Kochbati L., Plieskiene A., Casas F., Stojanovic S., Schneider G., Jeremic B.

Publicada: 1 ene 2015
Resumen:
Abstract Background To determine the optimal single-dose radiotherapy schedule for pain from bone metastases in a multi-centre, international, randomised trial. Patients and methods 651 patients were randomised to either 8 Gy (n = 325) or 4 Gy (n = 326) radiotherapy. Pain at 4, 8, 12, 24 and 52 weeks was assessed using a Categorical Scale (CS) and a Visual Analogue Scale (VAS). The primary endpoint was response at 4 weeks. Results There was no significant difference in patient demographics and other co-variates. The complete response (CR) rate and ORR (complete or partial response) for all follow-up times were higher after 8 Gy (p = 0.02). The Kaplan-Meier actuarial rate (categorical scale) at 4 weeks for ORR was 80% after 8 Gy compared to 68% after 4 Gy (p = 0.0015). 117 re-treatments were given of which 72 were in the 4 Gy group and 45 in 8 Gy arm (p = 0.01). Conclusions There was a marked consistent difference in pain relief at all time points in favour of 8 Gy. These data reinforce the case for single dose 8 Gy radiotherapy to be recommended for metastatic bone pain in all healthcare settings. © 2015 Elsevier Ireland Ltd.

Filiaciones:
Hoskin P.:
 Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN, United Kingdom

Rojas A.:
 Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN, United Kingdom

Fidarova E.:
 IAEA, Division of Human HealthVienna, Austria

Jalali R.:
 Tata Memorial Hospital, Mumbai, India

Mena Merino A.:
 Hospital Son Dureta, Palmas de Mallorca, Spain

Poitevin A.:
 Instituto Nacional CancerologíaMéxico DF, Mexico

Oucrif S.:
 Dep. Radiothérapie, Centre Hospitalier UniversitaireAlger, Algeria

Abdelwahab S.:
 Misr Oncology CentreCairo, Egypt

Kochbati L.:
 Radiotherapie carcinologique, Institut Salah AzaizTunis, Tunisia

Plieskiene A.:
 Institute of Oncology, Vilnius University, Lithuania

Casas F.:
 Radiation Oncology, Hospital Clínic i UniversitariBarcelona, Spain

Stojanovic S.:
 Institute of Oncology and RadiologyBelgrade, Serbia

Schneider G.:
 Fundacao Faculdade Federal de Ciencias Medicas, Porto Alegre, Brazil

Jeremic B.:
 IAEA, Division of Human HealthVienna, Austria
ISSN: 01678140
Editorial
ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, Países Bajos
Tipo de documento: Article
Volumen: 116 Número: 1
Páginas: 10-14
WOS Id: 000360510400003
ID de PubMed: 26026485

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