[Radiotherapy of bone metastases in France: A descriptive monocentric retrospective study].
Most cancers Radiother. 2018 Apr;22(2):148-162
Authors: Le Fèvre C, Antoni D, Thiéry A, Keller A, Truntzer P, Vigneron C, Clavier JB, Guihard S, Pop M, Schumacher C, Salze P, Noël G
PURPOSE: Bone metastases trigger ache and have an effect on sufferers’ high quality of life. Radiation remedy is without doubt one of the reference analgesic therapies. The target of this examine was to match the present practices of a French radiotherapy division for the therapy of uncomplicated bone metastases with information from the literature with a view to enhance and optimize the administration of sufferers.
MATERIAL AND METHODS: A retrospective monocentric examine of sufferers who underwent palliative irradiation of uncomplicated bone metastases was carried out.
RESULTS: Ninety-one sufferers had 116 therapies of uncomplicated bone metastases between January 2014 and December 2015, together with 44 males (48%) and 47 ladies (52%) with a mean age of 63years (25-88years). Main tumours mostly discovered have been breast most cancers (35%), lung most cancers (16%) and prostate most cancers (12%). The regimens used have been in 29% of circumstances 30Gy in ten fractions (group 30Gy), in 21% of circumstances 20Gy in 5 fractions (group 20Gy), in 22% of circumstances 8Gy in a single fraction (group 8Gy) and in 28% of circumstances 23.31Gy in three fractions of stereotactic physique irradiation (stereotactic group). The overall situation of the affected person (P<zero.001), ache rating and analgesic (P<zero.001), oligometastatic profile (P=zero.003) and practitioner expertise (P<zero.001) have been elements influencing the selection of the routine irradiation. Age (P=zero.46), intercourse (P=zero.14), anticancer therapies (P=zero.56), concomitant hospitalization (P=zero.14) and the space between the radiotherapy centre and residential (P=zero.87) didn’t affect the choice considerably. A complete of three circumstances of spinal compression and one case of post-therapeutic fracture have been noticed, occurring between one and 128days and 577days after irradiation, respectively. Eight % of all irradiated metastases have been reirradiated with a delay ranging between 13 and 434days after the primary irradiation. The re-irradiation fee was considerably greater after 8Gy (P=zero.02). The speed of dying was considerably decrease within the stereotactic arm (P<zero.001) and total survival was considerably higher within the stereotactic arm (P<zero.001).
CONCLUSION: This examine confirmed that sufferers’ analysed was akin to the inhabitants of various research. Predictive elements for the selection of the therapy routine have been recognized. Non-fractionnated remedy was underutilised whereas stereotactic therapy was more and more prescribed, exhibiting an evolution within the administration of sufferers.
PMID: 29602695 [PubMed – indexed for MEDLINE]