Local response and pathologic fractures following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy for spinal metastases - a randomized controlled trial

BMC Cancer
Tanja SpraveHarald Rief

Abstract

This was a prespecified secondary analysis of a randomized trial, which analyzed bone density following stereotactic body radiotherapy (SBRT) versus conventional three-dimensional conformal radiotherapy (3DCRT) as part of palliative management of painful spinal metastases. Fifty-five patients were enrolled in this single-institutional randomized exploratory trial (NCT02358720). Participants were randomly assigned to receive SBRT (single-fraction 24 Gy) or 3DCRT (30 Gy/10 fractions). Quantitative bone density was evaluated at baseline, 3 and 6 months in both irradiated and unirradiated spinal bodies, along with rates of pathologic fractures and vertebral compression fractures. As compared to baseline, bone density became significantly higher at 3 and 6 months following SBRT by a median of 33.8% and 72.1%, respectively (p < 0.01 for both). These figures in the 3DCRT cohort were 32.9% and 41.2%, respectively (p < 0.01 for both). There were no statistical differences in bone density between SBRT and 3DCRT at 3 (p = 0.629) or 6 months (p = 0.327). Subgroup analysis of osteolytic metastases showed an increase in bone density relative to baseline in the SBRT (but not 3DCRT) arm. Bone density in unaffected vertebrae did not show substa...Continue Reading

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Citations

Feb 18, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Wasif BalaLinda Probyn
May 24, 2019·Frontiers in Oncology·Kang Liang ZengSten Myrehaug
Oct 20, 2020·Current Osteoporosis Reports·Cari M WhyneMichael Hardisty
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Nov 24, 2021·Physical and Engineering Sciences in Medicine·Nicholas HardcastleTomas Kron
Jan 13, 2022·International Journal of Radiation Oncology, Biology, Physics·Bart J PielkenroodHelena M Verkooijen

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Clinical Trials Mentioned

NCT02358720

Software Mentioned

SAS
Syngo Osteo

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