Abstract
BackgroundTo evaluate the local response according to stability after radiotherapy (RT) with a special focus on quality-of-life (QoL), fatigue, pain and emotional distress in patients with unstable spinal bone metastases.MethodsIn this prospective trial, 30 patients were treated from September 2011 until March 2013. The stability of osteolytic metastases in the thoracic and lumbar spine was evaluated on the basis of the Taneichi-score after three and six months. EORTC QLQ-BM22, EORTC QLQ-FA13, and QSC-R10 were assessed at baseline, and three months after RT.ResultsAfter 3 months, 25% (n = 6) and after 6 months 33.3% (n = 8) were classified as stable. QoL, fatigue, and emotional distress showed no difference over the course. The pain response 3 months after RT showed a significant difference (p < 0.001). Pathological fractures occurred in 8.3% of the patients (n = 2) within six months following RT.ConclusionsOur trial demonstrated that RT can improve stability in one third of patients over a 6-months period with unstable spinal metastases. Importantly, for these patients pain relief was detected but RT had no impact on QoL, fatigue, and emotional distress.Trial registrationClinical trial identifier NCT01409720.
Highlights
Spinal bone metastases represent the most frequent site of skeletal metastasis [1]
The effect of palliative RT in patients with unstable bone metastases is not well analyzed. The aim of this prospective trial was to evaluate the local response according to stability after RT with a special focus on QoL, fatigue, pain and emotional distress in patients with unstable spinal bone metastases
The stability of each affected vertebral body was assessed according to the Taneichi score [6] on the basis of the computed tomography (CT) image recorded before RT and during follow-up restaging CT’s three and six months after RT (Figure 1)
Summary
Spinal bone metastases represent the most frequent site of skeletal metastasis [1]. The effects of bone metastases are a major clinical concern and result in pain at rest and during exercise, limitations in daily life, lower performance ability, risk of pathological fractures and neurologic deficits [2]. Standard clinical care of unstable metastases often includes patient immobilization either by means of an orthopedic thoracic corset or by confining the patient to bed in order to prevent pathological fractures, which further decreases patients’ quality-of-life (QoL). The effect of palliative RT in patients with unstable bone metastases is not well analyzed. The aim of this prospective trial was to evaluate the local response according to stability after RT with a special focus on QoL, fatigue, pain and emotional distress in patients with unstable spinal bone metastases. To evaluate the local response according to stability after radiotherapy (RT) with a special focus on quality-of-life (QoL), fatigue, pain and emotional distress in patients with unstable spinal bone metastases
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