Phase III randomized trial of 8 Gy in 1 fraction vs. 30 Gy in 10 fractions for palliation of painful bone metastases: preliminary results of RTOG 97-14

Hartsell, William F.; Scott, C.D.; Bruner, D.W.; Scarantino, Charles W.; Ivker, Robert; Roach, Mack; Suh, John H.; Demas, William F.; Movsas, Benjamin; Petersen, Ivy A.; Konski, A

doi:10.1016/s0360-3016(03)00823-x

Cited by 28 publications

(3 citation statements)

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“…Radiation Therapy Oncology Group (RTOG) 97-14 evaluated the ability of a single fraction of radiation therapy to relieve painful bone metastases from breast and prostate cancer compared to multiple fractions. (6) Three-year updated results have confirmed the earlier report of similar overall pain relief between fractionation schedules but with higher re-treatment rates in the 8 Gy fraction treatment,18% re-treatment rate, compared to 9% for patients treated with 30 Gy. (7)…”

Section: Introductionsupporting

confidence: 77%

Economic Analysis of Radiation Therapy Oncology Group 97-14

Konski

James

Hartsell³

et al. 2009

American Journal of Clinical Oncology

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Introduction RTOG 97-14 concluded a single fraction of radiation was as effective in relieving pain as multiple fractions in the treatment of patients with bone metastases. A statistically significant higher re-treatment rate, however, was noted in patients undergoing a single fraction treatment. The purpose of the analysis was to determine if multiple fraction treatment is cost-effective in treating patients with bone metastasis by preventing further re-treatment. Methods & Material A Markov model was used to evaluate the cost-effectiveness of 30 Gy in 10 fractions compared to 8 Gy in 1 fraction. Transition probabilities, cost and utilities were obtained from the clinical trial. Costs and outcomes were not discounted because of the short-time line for the study. Results The expected mean cost and quality adjusted survival in months for patients receiving 8 Gy in 1 fraction and 30 Gy in 10 fractions was $998 and 7.26 months and $2,316 and 9.53 months, respectively. The incremental cost-effectiveness ratio (ICER) was $6973/quality-adjusted life year. The results were sensitive to the utility of the post-treatment state for both single and multiple fraction treatment. Conclusion Single fraction treatment was the less expensive treatment in the treatment of patients with bone metastasis treated on RTOG 97-14.

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Section: Introductionsupporting

confidence: 77%

Economic Analysis of Radiation Therapy Oncology Group 97-14

Konski

James

Hartsell³

et al. 2009

American Journal of Clinical Oncology

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“…The RTOG trial 97-14 is an example of a large and recently reported trial that had as objectives (1) to determine whether 8 Gy in a single fraction provides equivalent pain relief compared to 30 Gy in 10 fractions for patients with painful bone metastasis, (2) to determine the duration of pain relief, (3) to determine the effect on quality of life measures; (4) to determine the incidence of pathologic fracture and (5) to determine cost-effectiveness of therapies in terms of cost/quality adjusted life years. Preliminary results (Hartsell et al, 2003) were presented in abstract form at the ASTRO meeting 2003 and confirm the data from the other trials: there was no difference in pain relief when comparing both treatment regimens. We can conclude that single fraction radiation treatment compared to multiple-fraction radiation treatment provides equal palliation and quality of life and based on a Dutch study (Van den Hout et al, 2003) single fraction treatment has a lower medical and societal cost.…”

Section: Results Of Published Controlled Clinical Trials On Dose and supporting

confidence: 56%

Pain control by ionizing radiation of bone metastasis

Vakaet¹,

Boterberg²

2004

Int. J. Dev. Biol.

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Pain treatment due to cancer is a large fraction of the care in a radiotherapy department. While radiation treatment is very effective in reducing pain, the pathophysiology of bone metastases remains very complex. Reducing the number of tumour cells by radiation will reduce the pressure in bone marrow, but the very rapid response to radiation treatment seen in some patients is probably related to the presence of highly radiosensitive inflammatory cells. In this review we give an overview of the pathophysiological mechanisms which lead to pain associated with bone metastasis and the impact of radiation treatment and other treatments on this mechanism.

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“…V. W. Stieber, 1 W. Hinson, 1 W. Kearns, 1 T. W. Huang, 1 R. Tucker, 2 K. M. Greven, 1 A. W. Blackstock, 1 R. Rosdahl, 1 S. Wells, 1 V. Alexander, 1 P. Shen, 3 J. Lovato 4 1 Radiation Oncology, Wake Forest University, Winston-Salem, NC, 2 Hematology and Oncology, Wake Forest University, Winston-Salem, NC, 3 Surgery, Wake Forest University, Winston-Salem, NC, 4 Public Health Sciences, Wake Forest University, Winston-Salem, NC Purpose/Objective: Stereotactic Body Radiotherapy (SBRT) is a treatment methodology used to treat small tumor volumes to high doses of radiation while minimizing dose to surrounding organs at risk. This abstract describes the results of an ongoing Phase I/II study evaluating palliative single-dose body radiosurgery.…”

Section: Bioanatomic Imaging To Assess Responsementioning

confidence: 99%