scholarly journals Stability and survival analysis of elderly patients with osteolytic spinal bone metastases after palliative radiotherapy

2019 ◽  
Vol 195 (12) ◽  
pp. 1074-1085 ◽  
Author(s):  
Tilman Bostel ◽  
Robert Förster ◽  
Ingmar Schlampp ◽  
Tanja Sprave ◽  
Sati Akbaba ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Elderly Patients ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Spinal Bone Metastases

scholarly journals EP-1652 Stability and survival of elderly patients after palliative radiotherapy of spinal bone metastases

2019 ◽  
Vol 133 ◽  
pp. S889-S890
Author(s):  
T. Bostel ◽  
R. Förster ◽  
I. Schlampp ◽  
T. Sprave ◽  
S. Akbaba ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Spinal Bone Metastases

Stability, Prognostic Factors and Survival of Spinal Bone Metastases in Malignant Melanoma Patients after Palliative Radiotherapy

2016 ◽  
Vol 102 (2) ◽  
pp. 156-161 ◽  
Author(s):  
Tilman Bostel ◽  
Robert Förster ◽  
Ingmar Schlampp ◽  
Robert Wolf ◽  
Andre Franke Serras ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Malignant Melanoma ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Spinal Bone Metastases ◽  
Melanoma Patients

scholarly journals Survival and stability of patients with urothelial cancer and spinal bone metastases after palliative radiotherapy

2017 ◽  
Vol 52 (2) ◽  
pp. 189-194
Author(s):  
Robert Foerster ◽  
Katharina Hees ◽  
Thomas Bruckner ◽  
Tilman Bostel ◽  
Ingmar Schlampp ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Urothelial Cancer ◽  
Cell Cancer ◽  
Palliative Radiotherapy ◽  
Local Response ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Spinal Bone Metastases ◽  
Fractionation Schedules

Abstract Background The aim of the study was to analyze survival and stability of patients with urothelial cell cancer and spinal bone metastases (SBM) after radiotherapy (RT). Furthermore, to assess the effects of RT on bone mineral density (BMD) as a local response in SBM after RT. Patients and methods Survival of 38 patients with 132 SBM from urothelial cancer, treated from January 2000 to January 2012, was calculated. Stability of irradiated thoracic and lumbar SBM was retrospectively evaluated in computed tomography (CT) scans using the validated Taneichi et al. score. Difference in BMD, measured in Hounsfield units (HU), of the SBM before and at 3 and 6 months after RT was analyzed. Results All patients died during follow-up. Overall survival (OS) after 6 months, 1 year and 2 years was 90%, 80% and 40%, respectively. Bone survival (BS) was 85%, 64% and 23% after 6 months, 1 year and 2 years, respectively. Survival from start of RT (RTS) was 42% after 6 months, 18% after 1 year and 5% after 2 years. Only 11% received bisphosphonates. Stability did not improve at 3 or 6 months after RT. BMD increased by 25.0 HU ± 49.7 SD after 3 months (p = 0.001) and by 24.2 HU ± 52.2 SD after 6 months (p = 0.037). Pain relief (> 2 points on the visual analogue scale) was achieved in only 27% of patients. Conclusions Benefit from palliative RT of painful or unstable SBM is limited in these patients and they should be carefully selected for RT. Shorter fractionation schedules may be preferred and outcome may improve with concomitant bisphosphonates.

scholarly journals Survival and stability of patients with urothelial cancer and spinal bone metastases after palliative radiotherapy

2017 ◽  
Vol 52 (2) ◽  
pp. 189-194 ◽  
Author(s):  
Robert Foerster ◽  
Katharina Hees ◽  
Thomas Bruckner ◽  
Tilman Bostel ◽  
Ingmar Schlampp ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Urothelial Cancer ◽  
Cell Cancer ◽  
Palliative Radiotherapy ◽  
Local Response ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Spinal Bone Metastases ◽  
Fractionation Schedules

Abstract Background The aim of the study was to analyze survival and stability of patients with urothelial cell cancer and spinal bone metastases (SBM) after radiotherapy (RT). Furthermore, to assess the effects of RT on bone mineral density (BMD) as a local response in SBM after RT. Patients and methods Survival of 38 patients with 132 SBM from urothelial cancer, treated from January 2000 to January 2012, was calculated. Stability of irradiated thoracic and lumbar SBM was retrospectively evaluated in computed tomography (CT) scans using the validated Taneichi et al. score. Difference in BMD, measured in Hounsfield units (HU), of the SBM before and at 3 and 6 months after RT was analyzed. Results All patients died during follow-up. Overall survival (OS) after 6 months, 1 year and 2 years was 90%, 80% and 40%, respectively. Bone survival (BS) was 85%, 64% and 23% after 6 months, 1 year and 2 years, respectively. Survival from start of RT (RTS) was 42% after 6 months, 18% after 1 year and 5% after 2 years. Only 11% received bisphosphonates. Stability did not improve at 3 or 6 months after RT. BMD increased by 25.0 HU ± 49.7 SD after 3 months (p = 0.001) and by 24.2 HU ± 52.2 SD after 6 months (p = 0.037). Pain relief (> 2 points on the visual analogue scale) was achieved in only 27% of patients. Conclusions Benefit from palliative RT of painful or unstable SBM is limited in these patients and they should be carefully selected for RT. Shorter fractionation schedules may be preferred and outcome may improve with concomitant bisphosphonates.

Stability of Spinal Bone Metastases and Survival Analysis in Renal Cancer after Radiotherapy

2015 ◽  
Vol 101 (6) ◽  
pp. 614-620 ◽  
Author(s):  
Ingmar Schlampp ◽  
Helge Lang ◽  
Robert Förster ◽  
Robert Wolf ◽  
Tilman Bostel ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Bone Metastases ◽  
Renal Cancer ◽  
Spinal Bone Metastases

Elderly Patients With Painful Bone Metastases Should be Offered Palliative Radiotherapy

2010 ◽  
Vol 76 (5) ◽  
pp. 1500-1506 ◽  
Author(s):  
Sarah Campos ◽  
Roseanna Presutti ◽  
Liying Zhang ◽  
Nadia Salvo ◽  
Amanda Hird ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Painful Bone Metastases

Comparison of pain response and functional interference outcomes between spinal and non-spinal bone metastases treated with palliative radiotherapy

2011 ◽  
Vol 20 (3) ◽  
pp. 633-639 ◽  
Author(s):  
Liang Zeng ◽  
Edward Chow ◽  
Liying Zhang ◽  
Shaelyn Culleton ◽  
Lori Holden ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Pain Response ◽  
Spinal Bone Metastases ◽  
Functional Interference

scholarly journals EP-1632 Response prediction of palliative radiotherapy to painful spinal bone metastases

2019 ◽  
Vol 133 ◽  
pp. S879-S880
Author(s):  
J. Akhgar ◽  
J.C. Peeken ◽  
S.U. Pigorsch ◽  
S.E. Combs
Keyword(s):  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Response Prediction ◽  
Spinal Bone Metastases

scholarly journals The Role of Palliative Radiotherapy in the Treatment of Spinal Bone Metastases from Head and Neck Tumors—A Multicenter Analysis of a Rare Event

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1950
Author(s):  
Tilman Bostel ◽  
Alexander Rühle ◽  
Tilmann Rackwitz ◽  
Arnulf Mayer ◽  
Tristan Klodt ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Head And Neck ◽  
Predictive Factors ◽  
Palliative Radiotherapy ◽  
Karnofsky Performance Score ◽  
Spinal Bone Metastases ◽  
Multiple Observations ◽  
Neurologic Deficits ◽  
Time Varying Covariates

This retrospective multi-center analysis aimed to assess the clinical response and stabilizing effects of palliative radiotherapy (RT) for spinal bone metastases (SBM) in head and neck cancer (HNC), and to establish potential predictive factors for stability and overall survival (OS). Patients included in this analysis were treated at the University Hospitals of Mainz, Freiburg, and Heidelberg between 2001 and 2019. Clinical information was taken from the medical records. The stability of affected vertebral bodies was assessed according to the validated spine instability neoplastic score (SINS) based on CT-imaging before RT, as well as 3 and 6 months after RT. OS was quantified as the time between the start of palliative RT and death from any cause or last follow-up. Potential predictive factors for stability and OS were analyzed using generalized estimating equations and Cox regression for time-varying covariates to take into account multiple observations per patient. The mean follow-up time of 66 included patients after the first palliative RT was 8.1 months (range 0.3–85.0 months). The majority of patients (70%; n = 46) had squamous cell carcinomas (SCC) originating from the pharynx, larynx and oral cavity, while most of the remaining patients (26%; n = 17) suffered from salivary glands tumors. A total of 95 target volumes including 178 SBM were evaluated that received a total of 81 irradiation series. In patients with more than one metastasis per irradiated region, only the most critical bone metastasis was analyzed according to the SINS system. Prior to RT, pain and neurologic deficits were present in 76% (n = 72) and 22% (n = 21) of irradiated lesions, respectively, and 68% of the irradiated lesions (n = 65) were assessed as unstable or potentially unstable prior to RT. SBM-related pain symptoms and neurologic deficits responded to RT in 63% and 47% of the treated lesions, respectively. Among patients still alive at 3 and 6 months after RT with potentially unstable or unstable SBM, a shift to a better stability class according to the SINS was observed in 20% and 33% of the irradiated SBM, respectively. Pathological fractures of SBM were frequently detected before the start of irradiation (43%; n = 41), but after RT, new fractures or increasing vertebral body sintering within the irradiated region occurred rarely (8%; n = 8). A pathological fracture before RT was negatively associated with stabilization 6 months after RT (OR 0.1, 95% CI 0.02–0.49, p = 0.004), while a Karnofsky performance score (KPS) ≥ 70% was associated positively with a stabilization effect through irradiation (OR 6.09, 95% CI 1.68–22.05, p = 0.006). Mean OS following first palliative RT was 10.7 months, and the KPS (≥70% vs. <70%) was shown to be a strong predictive factor for OS after RT (HR 0.197, 95% CI 0.11–0.35, p < 0.001). There was no significant difference in OS between patients with SCC and non-SCC. Palliative RT in symptomatic SBM of HNC provides sufficient symptom relief in the majority of patients, while only about one third of initially unstable SBM show re-stabilization after RT. Since patients in our multi-center cohort exhibited very limited OS, fractionation schemes should be determined depending on the patients’ performance status.

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