eprintid: 25169 rev_number: 14 eprint_status: archive userid: 1589 dir: disk0/00/02/51/69 datestamp: 2018-07-30 12:09:44 lastmod: 2024-03-19 03:04:58 status_changed: 2018-07-30 12:09:44 type: article metadata_visibility: show creators_name: Sprave, Tanja creators_name: Hees, Katharina creators_name: Bruckner, Thomas creators_name: Foerster, Robert creators_name: Bostel, Tilman creators_name: Schlampp, Ingmar creators_name: Shafie, Rami El creators_name: Nicolay, Nils Henrik creators_name: Debus, Juergen creators_name: Rief, Harald title: The influence of fractionated radiotherapy on the stability of spinal bone metastases: a retrospective analysis from 1047 cases subjects: ddc-610 divisions: i-850300 divisions: i-911400 divisions: i-911800 abstract: Background: The effect of radiotherapy, in particular the application of different multi-fraction schedules in the management of unstable spinal bone metastases (SBM), is incompletely understood. This study aims to compare the radiological response regarding various dose and fractionation schedules of radiotherapy in the palliative treatment of SBM. Methods: We retrospectively assessed 1047 patients with osteolytic SBM, treated with palliative radiotherapy at our department between 2000 and 2015. Lung cancer (40.2%), breast (16.7%) and renal cancer (15.2%) were the most common solid tumors in this study. Different common multi-fraction regimen (5x4Gy, 10x3Gy, 14 × 2.5Gy and 20x2Gy) were compared with regard to radiological response and recalcification at 3 and 6 months after radiotherapy. The Taneichi score was used for classification of osteolytic SBM. Results: Median follow up was 6.3 months. The median overall survival (OS) in the short-course radiotherapy (SCR) group using less than 10 treatment fractions was 5.5 months vs. 9.5 months in the long-course radiotherapy (LCR) group using in excess of 10 fractions (log rank p < .0001). Overall survival (OS) in the SCR group after 3 and 6 months was 66.8 and 49.1%, respectively vs 80.9 and 61.5%, respectively in the LCR group. 17.6% (n = 54/306) and 31.1% (n = 89/286) of unstable SBM were classified as stable in the SCR group at 3 and 6 months post radiotherapy, respectively (p < .001 for both). In the LCR group, 24.1% (n = 28/116) and 34.2% (n = 38/111) of unstable SBM were stabilized after 3 and 6 months, respectively (p < .001 for both). Conclusions: Our study shows no significant difference in stabilization achieving recalcification rates between multi-fraction schedules (SCR vs. LCR) in the palliative management of unstable SBM. Both groups with multi-fraction regimen demonstrate a stabilizing effect following 3 and 6 months after radiotherapy. date: 2018 publisher: BioMed Central id_scheme: DOI ppn_swb: 1655377876 own_urn: urn:nbn:de:bsz:16-heidok-251696 language: eng bibsort: SPRAVETANJTHEINFLUEN2018 full_text_status: public publication: Radiation Oncology volume: 13 number: 134 place_of_pub: London pagerange: 1-9 issn: 1748-717X citation: Sprave, Tanja ; Hees, Katharina ; Bruckner, Thomas ; Foerster, Robert ; Bostel, Tilman ; Schlampp, Ingmar ; Shafie, Rami El ; Nicolay, Nils Henrik ; Debus, Juergen ; Rief, Harald (2018) The influence of fractionated radiotherapy on the stability of spinal bone metastases: a retrospective analysis from 1047 cases. Radiation Oncology, 13 (134). pp. 1-9. ISSN 1748-717X document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/25169/1/13014_2018_Article_1082.pdf