Efficacy of hypofractionated radiotherapy with simultaneous integrated boost for non-osteogenic spinal metastases
10.3760/cma.j.cn113030-20230914-00091
- VernacularTitle:大分割同步加量放疗对肿瘤非成骨性脊柱转移疗效的研究
- Author:
Fadong YIN
1
;
Yuyan GAO
;
Xianxiu NAN
;
Xuan LIU
;
Xianbin ZHENG
;
Xinjue SHI
;
Jing YUAN
;
Qiteng LIU
Author Information
1. 首都医科大学附属北京潞河医院放疗科，北京 101100
- Keywords:
Neoplasm metastasis;
Bone metastasis;
Spinal metastasis;
Stereotactic body radiotherapy;
Hypofractionated radiotherapy therapy;
Simultaneous integrated boo
- From:
Chinese Journal of Radiation Oncology
2024;33(10):928-934
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the feasibility and efficacy of hypofractionated radiotherapy with simultaneous integrated boost (HFRT-SIB) for patients with non-osteogenic spinal metastases who were not suitable for stereotactic body radiotherapy (SBRT).Methods:A totoal of 26 spinal metastatic lesions in 24 patients with non-osteogenic spinal metastases admitted to Beijing Luhe Hospital affiliated to Capital Medical University from March 2020 to April 2023 were retrospectively analyzed. In our institution, a higher-dose fractionated regimen for spinal metastases was introduced, at a dose of 3 Gy/f ×10 times (5 times a week, once a day) to the clinical target volume (CTV), and simultaneous integrated boost (SIB) of 4 Gy/f ×10 times (5 times a week, once a day) to the gross tumor volume (GTV). The primary endpoint was the overall relief (OR) rates of pain at 12 and 24 weeks post-radiotherapy, while secondary endpoints included the pain response time and duration of pain relief, the incidence of adverse events post-radiotherapy, and the 1-year overall survival (OS) rate. The differences before and after treatment were analyzed by Wilcoxon signed-rank test. OS was assessed using Kaplan-Meier method.Results:The median follow-up was 11.7 (8.0, 17.0) months. At 12 weeks post-radiotherapy, 92% (22/24) of patients achieved OR, and 81% (17/21) obtained OR at 24 weeks post-radiotherapy. The median pain response time was 4 (3, 5) d. At the last follow-up, 42% (10/24) of patients maintained pain relief for over 1 year, with a median duration of pain relief up to 11.0 (6.0, 16.9) months. The 1-year OS rate was 66.3%, and no patients experienced grade 3 or higher acute or chronic adverse events.Conclusion:HFRT-SIB can effectively alleviate pain, and achieve sustained pain control, and does not lead to severe adverse effects in patients with non-osteogenic spinal metastases.
