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Local control of 1-5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology.
Kowalchuk, Roman O; Cousins, David; Spencer, Kelly M; Richardson, K Martin; Larner, James M; Showalter, Timothy N; McAllister, William H; Sheehan, Jason P; Kersh, C Ronald; Dutta, Sunil W.
Afiliação
  • Kowalchuk RO; Department of Radiation Oncology, Mayo Clinic, Rochester, United States.
  • Cousins D; Department of Radiation Oncology, University of Virginia, Charlottesville, United States.
  • Spencer KM; Radiosurgery Center, University of Virginia/Riverside, Newport News, United States.
  • Richardson KM; Radiosurgery Center, University of Virginia/Riverside, Newport News, United States.
  • Larner JM; Department of Radiation Oncology, University of Virginia, Charlottesville, United States.
  • Showalter TN; Department of Radiation Oncology, University of Virginia, Charlottesville, United States.
  • McAllister WH; Department of Neurosurgery, Riverside Regional Medical Center, Newport News, United States.
  • Sheehan JP; Department of Neurosurgery, University of Virginia, Charlottesville, United States.
  • Kersh CR; Radiosurgery Center, University of Virginia/Riverside, Newport News, United States.
  • Dutta SW; Department of Radiation Oncology, Emory University, Atlanta, United States.
Rep Pract Oncol Radiother ; 26(6): 883-891, 2021.
Article em En | MEDLINE | ID: mdl-34992859
ABSTRACT

BACKGROUND:

This analysis evaluates the impacts of biologically effective dose (BED) and histology on local control (LC) of spinal metastases treated with highly conformal radiotherapy to moderately-escalated doses. MATERIALS AND

METHODS:

Patients were treated at two institutions from 2010-2020. Treatments with less than 5 Gy per fraction or 8 Gy in 1 fraction were excluded. The dataset was divided into three RPA classes predictive of survival (1). The primary endpoint was LC.

RESULTS:

223 patients with 248 treatments met inclusion criteria. Patients had a median Karnofsky Performance Status (KPS ) of 80, and common histologies included breast (29.4%), non-small cell lung cancer (15.7%), and prostate (13.3%). A median 24 Gy was delivered in 3 fractions (BED 38.4 Gy) to a median planning target volume (PTV) of 37.3 cc. 2-year LC was 75.7%, and 2-year OS was 42.1%. Increased BED was predictive of improved LC for primary prostate cancer (HR = 0.85, 95% CI 0.74-0.99). Patients with favorable survival (RPA class 1) had improved LC with BED ≥ 40 Gy (p = 0.05), unlike the intermediate and poor survival groups. No grade 3-5 toxicities were reported.

CONCLUSIONS:

Moderately-escalated treatments were efficacious and well-tolerated. BED ≥ 40 Gy may improve LC, particularly for prostate cancer and patients with favorable survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2021 Tipo de documento: Article