High dose and compartmental target volume may improve patient outcome after radiotherapy for pelvic bone metastases from hepatocellular carcinoma

Abstract

PurposePelvic bone metastases are difficult to treat because of complex pelvic bone anatomy and the proximity of normal organs. The adequacy of radiation dose and field coverage was evaluated.Patients and methodsWe analyzed 146 cases of pelvic bone metastases from HCC treated with radiotherapy (RT). Bone metastases were confirmed using CT/MRI. Subjective pain response was assessed using the visual analogue scale, and treatment-related toxicity with the Common Terminology Criteria for Adverse Events v3.0. Local failure free survival (LFFS) and overall survival were estimated using the Kaplan-Meier method.ResultsThe local control rate was 80.1% and the pain control rate was 68.5%. Compartmental target volume (CTV), encompassing the whole compartment of the involved bone, was found to be a significant factor (1-year LFFS, 78% vs. 50%; p=0.001). Sites of metastasis were categorized as either upper or lower pelvic bone; both categories showed improved local control with CTV. Metastatic lesions that received more than 50 Gy of EQD2 showed more partial response in pain after RT (58% vs. 79%; p=0.007). No patient showed toxicity higher than Grade IV.ConclusionCompartmental RT targeted to the involved bone was associated with improved local control and LFFS. High-dose radiation was associated with an improved treatment response.

Intensive Local Radiotherapy Is Associated With Better Local Control and Prolonged Survival in Bone-Metastatic Nasopharyngeal Carcinoma Patients

“…Besides, many patients presented with oligometastasis, and longer survival durations were often observed among them, thus the short fractionation schedules, which sometimes required the need for retreatment (18), were less adequate. Our results suggested the use of intensive dose prescription, which was consistent with the results in hepatocellular cancer (HCC), renal and prostate cancers (19)(20)(21)(22). Kim et al (20) selected HCC patients who were followed up for at least 1 year and a positive dose-response relationship was observed.…”

Retracted: Analgesic effects of microRNA‐129‐5p against bone cancer pain through the EphB1/EphrinB2 signaling pathway in mice

“…Bone is the most common site to be influenced via cancer metastases in breast cancer, hepatocellular carcinoma, as well as prostate cancer. [1][2][3] It is known that the morbidity and mortality mainly attribute to bone metastases from tumors inducing skeletal remodeling, fractures, and pain. 4 The process of bone metastases includes tumor…”

MicroRNA-93-5p may participate in the formation of morphine tolerance in bone cancer pain mouse model by targeting Smad5

“…At postmortem examination, up to 70% of patients dying of these cancers presents bone metastatic [1–3]. Also, in the United States, it has been estimated that tumor metastasis to the bone affects more than 400,000 persons each year [2].…”