scholarly journals Systematic Review of the Role of Stereotactic Radiotherapy for Bone Metastases

2019 ◽  
Vol 111 (10) ◽  
pp. 1023-1032 ◽  
Author(s):  
Katie L Spencer ◽  
Joanne M van der Velden ◽  
Erin Wong ◽  
Enrica Seravalli ◽  
Arjun Sahgal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastases ◽  
Local Control ◽  
Stereotactic Radiotherapy ◽  
Palliative Radiotherapy ◽  
Included Study ◽  
Pain Response ◽  
Solid Organ ◽  
International Consensus ◽  
Conventional Radiotherapy

Abstract Background Stereotactic radiotherapy (SBRT) might improve pain and local control in patients with bone metastases compared to conventional radiotherapy, although an overall estimate of these outcomes is currently unknown. Methods A systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Embase, and Cochrane databases were systematically searched to identify studies reporting pain response and local control among patients with bone metastases from solid-organ tumors who underwent SBRT in 1–6 fractions. All studies prior to April 15, 2017, were included. Study quality was assessed by predefined criteria, and pain response and local control rates were extracted. Results A total of 2619 studies were screened; 57 were included (reporting outcomes for 3995 patients) of which 38 reported pain response and 45 local control rates. Local control rates were high with pain response rates above those previously reported for conventional radiotherapy. Marked heterogeneity in study populations and delivered treatments were identified such that quantitative synthesis was not appropriate. Reported toxicity was limited. Of the pain response studies, 73.7% used a retrospective cohort design and only 10.5% used the international consensus endpoint definitions of pain response. The median survival within the included studies ranged from 8 to 30.4 months, suggesting a high risk of selection bias in the included observational studies. Conclusions This review demonstrates the potential benefit of SBRT over conventional palliative radiotherapy in improving pain due to bone metastases. Given the methodological limitations of the published literature, however, large randomized trials are now urgently required to better quantify this benefit.

scholarly journals EP-1402: Impact of SBRT on pain and local control for bone metastases: a systematic review and meta-analysis

2017 ◽  
Vol 123 ◽  
pp. S749
Author(s):  
J.M. Van der Velden ◽  
A.S. Gerlich ◽  
E. Wong ◽  
E. Chow ◽  
M. Intven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastases ◽  
Local Control ◽  
Meta Analysis

International consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases

2002 ◽  
Vol 64 (3) ◽  
pp. 275-280 ◽  
Author(s):  
Edward Chow ◽  
Jackson S.Y. Wu ◽  
Peter Hoskin ◽  
Lawrence R. Coia ◽  
Soren M. Bentzen ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
International Consensus

scholarly journals Optimal dose-fractionation schedule of palliative radiotherapy for patients with bone metastases: a protocol for systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033120 ◽  
Author(s):  
Xiaofang Tang ◽  
Qiancheng Hu ◽  
Ye Chen ◽  
Xin Wang ◽  
Xiaofen Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastases ◽  
Meta Analysis ◽  
Palliative Radiotherapy ◽  
Optimal Dose ◽  
Dose Fractionation ◽  
Cochrane Library ◽  
Assessment Development ◽  
Fractionation Schedule ◽  
American Society

IntroductionThe optimal dose-fractionation schedule of palliative radiotherapy has been debated in patients with bone metastases. Our objective is to comprehensively compare multiple fraction schedules with single fraction radiotherapy in terms of efficacy and toxicities by performing a systematic review and network meta-analysis.Methods and analysisElectronic searches of titles/abstracts of palliative radiotherapy for bone metastases will be performed, using PubMed, Cochrane Library, Embase,clinical trials, American Society for Therapeutic Radiology and Oncology and European Society of Radiotherapy and Oncology. The primary outcome of interest is the incidence of skeletal-related event following palliative radiotherapy for bone metastases in prospective studies. The risk of bias and quality of evidence will be evaluated based on Cochrane Collaboration’s tool and Grades of Recommendation, Assessment, Development and Evaluation in the network meta-analysis. We will conduct subgroup analysis and sensitivity analysis regardless of heterogeneity estimates.Ethics and disseminationThis study will synthesise the evidence regarding dose-fractionation schedule of palliative radiotherapy in patients with bone metastases. We hope the findings from this study will help clinicians and patients select optimum palliative radiotherapy by identifying the optimal dose-fractionation schedule of palliative radiotherapy with the most value in terms of patient-important outcomes. The evidence obtained from network meta-analysis will help to guide head-to-head research in the future. The results will be disseminated through international conference reports and peer-reviewed manuscripts. Ethics review board is not required for this network meta-analysis.PROSPERO registration numberCRD42019135195.

scholarly journals Palliative radiotherapy for painful lymph node metastases

2021 ◽  
Author(s):  
Kohsei Yamaguchi ◽  
Tetsuo Saito ◽  
Ryo Toya ◽  
Etsushi Tomitaka ◽  
Tomohiko Matsuyama ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Short Form ◽  
Palliative Radiotherapy ◽  
Brief Pain Inventory ◽  
Pain Interference ◽  
Primary Study ◽  
Pain Response ◽  
International Consensus ◽  
Node Metastases

Abstract Background: There is limited evidence concerning radiotherapy for painful lymph node metastases (PLM). We evaluated the effectiveness of radiotherapy for PLM using the International Consensus Endpoint in a subgroup analysis of a prospective observational study.Methods: In the primary study, 302 patients received radiotherapy for painful tumors. Among them, those treated with palliative radiotherapy for PLM were analyzed in the present study. We used the Brief Pain Inventory short form to evaluate the intensity of pain and the pain interference in patient's life. We collected the Brief Pain Inventory and analgesic data at baseline and at 1, 2, and 3 months after the start of radiotherapy. Pain response was assessed using the International Consensus Endpoint. Patients were diagnosed with a predominance of other pain (POP) if non-index pain of a malignant or unknown origin was present and had a greater 'worst pain' score than the index pain.Results: Radiotherapy for PLM was performed on 25 patients. In total, 15 (60%) patients experienced a pain response. The pain response rates for evaluable patients were 66%, 67%, and 57% at 1-, 2-, and 3-month follow-ups, respectively. At baseline and at 1, 2, and 3 months, the median index pain scores were 7, 2, 0, and 0.5, respectively. At 1 month, all pain interference scores were significantly reduced from baseline. Four (16%) patients experienced POP within three months.Conclusion: Radiotherapy for PLM improved pain intensity and pain interference. Palliative radiotherapy may be a viable treatment option for PLM.

scholarly journals Hypofractionated stereotactic radiotherapy for intracranial meningioma: a systematic review

2018 ◽  
Vol 6 (5) ◽  
pp. 346-353 ◽  
Author(s):  
Eric K Nguyen ◽  
Timothy K Nguyen ◽  
Gabe Boldt ◽  
Alexander V Louie ◽  
Glenn S Bauman
Keyword(s):  
Systematic Review ◽  
Local Control ◽  
Stereotactic Radiotherapy ◽  
Late Toxicity ◽  
Cranial Neuropathy ◽  
Intracranial Meningioma ◽  
Eligibility Criteria ◽  
Hypofractionated Stereotactic Radiotherapy ◽  
Fractionated Radiotherapy

Abstract Background The availability of image guidance and intensity modulation has led to the increasing use of hypofractionated stereotactic radiotherapy (hSRT) as an alternative to conventionally fractionated radiotherapy or radiosurgery for intracranial meningiomas (ICMs). As the safety and efficacy of this approach is not well characterized, we conducted a systematic review of the literature to assess the clinical outcomes of hSRT in the setting of ICMs. Methods A systematic review of Medline and EMBASE databases was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies were retrospective or prospective series that examined an ICM population of ≥10 patients, delivered >1 fraction of photon hSRT (≥2.5 Gy per fraction), and had a median follow-up of ≥2 years. Descriptive statistics were generated for included studies. Results Of 1480 initial studies, 14 met eligibility criteria for inclusion, reporting on 630 patients (age range, 18-90) treated for 638 tumors. Primary radiotherapy was delivered in 37% of patients, 36% had radiation following surgery, and surgical details were unavailable for 27%. In 474 tumors assessed for radiologic response, 78% remained stable, 18% decreased in size, and 4% increased in size. Crude local control was 90%-100% as reported in 10 studies. The median late toxicity rate was 10%. The most common significant late toxicities were decreased visual acuity and new cranial neuropathy. Conclusions With limited follow-up, the available literature suggests hSRT for ICMs has local control and toxicity profiles comparable to other radiotherapy approaches. Confirmation in larger patient cohorts with a longer duration of follow-up is required.

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