Quality of Life After Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Patients With Bone Metastases

Pielkenrood, Bart J.; Gal, Roxanne; Kasperts, N.; Verhoeff, Joost J.C.; Bartels, M.; Seravalli, Enrica; Linden, Yvette M. van der; Monninkhof, Evelyn M.; Verlaan, Jorrit‐Jan; Velden, Joanne M. van der; Verkooijen, Helena M.

doi:10.1016/j.ijrobp.2021.12.163

Cited by 13 publications

(20 citation statements)

References 37 publications

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“…2). There appears to be a more gradual increase in SBRT use over the study period, correlating with increasing interest and the emerging evidence on the role of SBRT for local control 10 and symptom control [11][12][13][14][15] (Table 5). This also corresponds to the period when there were multiple recruiting SBRT trials for BM in Victoria, including the local single-institutional POPSTAR trial for metastatic prostate cancer 8 and BOSTON trial for metastatic breast cancer, 16 as well as international trials, which several Victorian institutions contributed to, such as SABR-COMET, SC24/TROG1706 and CORE trials.…”

Section: Discussionmentioning

confidence: 83%

Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria

et al. 2022

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Introduction: To describe the pattern of the use of advanced radiation therapy (RT) techniques, including intensity-modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body RT (SBRT) for the management of bone metastases (BM), and the associated factors in Victoria. Methods: We used a population-based cohort of patients from the state-wide Victorian Radiotherapy Minimum Data Set (VRMDS) who received RT for BM between 2012 and 2017. The primary outcome was proportion of RT courses using advanced RT techniques. The Cochran-Armitage test for trend was used to evaluate temporal trend in advanced RT use. Multinomial logistic regression was used to identify factors associated with advanced RT use. Results: A total of 18,158 courses of RT were delivered to 10,956 patients-16,626 (91.6%) courses were 3D conformal RT, 857 (4.7%) IMRT/VMAT and 675 (3.7%) SBRT. There was a sharp increase in IMRT/VMAT use from <1% in 2012-2015, to 10.1% in 2016 and 16.3% in 2017 (P-trend < 0.001). Increase in SBRT use was more gradual, from 1.2% in 2012 to 4.8% in 2016 and 5.5% in 2017 for SBRT (P-trend<0.001). In multivariate analyses, year of RT was the strongest predictor of IMRT/VMAT use (OR = 41; 95%CI = 25-67; P < 0.001, comparing 2012-2013 and 2016-2017). Primary tumour type (prostate cancer) was the strongest predictor of SBRT use (OR = 6.07; 95% CI = 4.19-8.80; P < 0.001). Conclusion: Overall, there was increasing trend in the use of advanced RT techniques for BM in Victoria, with a distinct pattern for IMRT/VMAT compared with SBRT -SBRT uptake was more gradual while IMRT/VMAT uptake was abrupt, occurring contemporaneously with Medicare Benefit Scheme funding changes in 2016.

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Section: Discussionmentioning

confidence: 83%

Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria

et al. 2022

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“…Six trials used a total of 12 QOL instruments to compare the two treatment groups (Table 3 ) [ 10 , 11 , 15 , 16 , 22 , 23 ]. Seven QOL instruments showed no significant differences between the arms in all domains at all recorded time points [ 10 , 11 , 16 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven QOL instruments showed no significant differences between the arms in all domains at all recorded time points [ 10 , 11 , 16 , 23 ]. Two QOL instruments [ 11 , 15 ] favoured SBRT and three [ 10 , 22 ] favoured cEBRT. Reproducible results to confirm the superiority of either SBRT or cEBRT could not be produced.…”

Section: Resultsmentioning

confidence: 99%

Stereotactic body radiotherapy versus conventional radiotherapy for painful bone metastases: a systematic review and meta-analysis of randomised controlled trials

et al. 2022

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Background Stereotactic body radiotherapy (SBRT) is a promising approach in treating painful bone metastases. However, the superiority of SBRT over conventional external beam radiotherapy (cEBRT) remains controversial. Therefore, this systematic review and meta-analysis of randomised controlled trials was conducted to compare SBRT and cEBRT for the treatment of bone metastases. Methods A search was conducted using PubMed on January 22, 2022, with the following inclusion criteria: (i) randomised controlled trials comparing SBRT with cEBRT for bone metastases and (ii) endpoint including pain response. Effect sizes across studies were pooled using random-effects models in a meta-analysis of risk ratios. Results A total of 1246 articles were screened, with 7 articles comprising 964 patients (522 and 442 patients in the SBRT and cEBRT arms, respectively) meeting the inclusion criteria. The overall pain response (OR) rates of bone metastases at 3 months were 45% and 36% in the SBRT and cEBRT arms, respectively. The present analyses showed no significant difference between the two groups. In four studies included for the calculation of OR rates of spinal metastases at three months, the OR rates were 40% and 35% in the SBRT and cEBRT arms, respectively, with no significant difference between the two groups. The incidence of severe adverse effects and health-related quality of life outcomes were comparable between the two arms. Conclusions The superiority of SBRT over cEBRT for pain palliation in bone metastases was not confirmed in this meta-analysis. Although SBRT is a standard of care for bone metastases, patients receiving SBRT should be selected appropriately.

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“…Nguyen et al [27] found in a phase II trial that SBRT had higher rates of pain response. Indeed, several studies have been published comparing the effectiveness between SBRT and conventional RT [32][33][34][35][36][37]. Indeed, there are potential disadvantages of SBRT, including possible increased pain flare or a higher incidence of radiation-induced fractures [38].…”

Section: Discussionmentioning

confidence: 99%

Quality of life improvement in patients with bone metastases undergoing palliative radiotherapy

Cañón

Gómez-Iturriaga

Casquero

et al. 2022

Rep Pract Oncol Radiother.

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Quality of Life After Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Patients With Bone Metastases

Cited by 13 publications

References 37 publications

Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria

Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria

Stereotactic body radiotherapy versus conventional radiotherapy for painful bone metastases: a systematic review and meta-analysis of randomised controlled trials

Quality of life improvement in patients with bone metastases undergoing palliative radiotherapy

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