Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique
Publication year
2018Source
Journal of Radiation Oncology, 7, 1, (2018), pp. 17-26ISSN
Publication type
Article / Letter to editor
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Organization
Radiation Oncology
Journal title
Journal of Radiation Oncology
Volume
vol. 7
Issue
iss. 1
Page start
p. 17
Page end
p. 26
Subject
Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health SciencesAbstract
Background: Conventional radiotherapy for painful spinal metastases can be delivered with a single posterior-anterior (PA) or two opposed anterior-posterior (APPA) fields. We studied the effectiveness and toxicity of both techniques and studied whether treatment technique was predictive for abdominal and skin toxicity. Patients and methods: Within the Dutch Bone Metastasis Study, 343 patients received 8 Gray in a single fraction or 24 Gray in six fractions for painful spinal metastases. Treatment technique was not randomized. At baseline and weekly during follow-up, patients reported pain and other physical complaints. Any complaint increasing within 4 weeks after treatment was noted as a side effect. Pain response was calculated according to international standards, taking into account changes in pain score and medication. Repeated measurement analyses and multivariate logistic analyses were performed. Results: Patients were mainly treated on the thoracic (34%) and lumbar (53%) spine and 73% received a PA field. Pain response was similar between both techniques (74%). In patients treated at the thoraco-lumbar and lumbar spine, with multiple fractions, significantly more abdominal complaints were noticed. In multivariate analysis, radiotherapy technique did not predict for side effects. Conclusion: Conventional radiotherapy of painful spinal metastases provides limited toxicity. Radiotherapy technique is not an independent predictor of abdominal and skin toxicity of irradiation.
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- Academic publications [238441]
- Electronic publications [122514]
- Faculty of Medical Sciences [90373]
- Open Access publications [97509]
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