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Bone Metastases pp 185–193Cite as

Radiotherapy And Bone Metastases

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Part of the book series: Cancer Metastasis – Biology and Treatment ((CMBT,volume 12))

Abstract

The optimal treatment of bone metastases in cancer patients is one of the major challenges in palliative medicine. Patients are confronted with complaints of bone metastases increasingly as life expectancy improves with more systemic therapies. Radiotherapy is an effective, often applied, palliative, non-invasive, local treatment modality for bone metastases. In this chapter the authors discuss the history of different fractionation schedules, the effectiveness of radiotherapy to treat pain, and it’s role in prevention of pathological fracturing by inducing remineralization. Also, the treatment of neurological deficits due to spinal cord or nerve compression will be discussed. Lastly, the issues on re-irradiation of bone metastases are mentioned.

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References

  1. Sze WM, Shelley M, Held I, et al. (2004) Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD004721. DOI: 10.1002/14651858. CD004721

    Google Scholar 

  2. Chow E, Harris K, Fan G, et al. (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25: 1423–1436

    Article  PubMed  Google Scholar 

  3. Wu JS, Wong R, Johnston M, et al. (2003) Meta-analysis of dose-fractionation radiotherapy trials for the palliation of painful bone metastases. Int J Radiat Oncol Biol Phys 55: 594–605

    PubMed  Google Scholar 

  4. Koswig S, Budach V (1999) Remineralization and pain relief in bone metastases after different radiotherapy fractions (10 times 3\,Gy versus. 1 time 8\,Gy). A prospective study. Strahlenther Onkol 175: 500–508

    Article  PubMed  CAS  Google Scholar 

  5. Rades D, Stalpers L, Veninga T (2005) Evaluation of five radiation schedules and prognostic factors for metastastic spinal cord compression in a series of 1304 patients. J Clin Oncol 23: 3366–3375

    Article  PubMed  Google Scholar 

  6. Maranzano E, Frattegiani A, Rossi R, et al. (2002) Randomized trial of two different hypofractionated radiotherapy schedules (8 Gy × 2 versus 5 Gy × 3; 3 Gy × 5) in metastatic spinal cord compression (MSCC). Radiother Oncol 64(Suppl.1):S82

    Google Scholar 

  7. Lievens Y, Kesteloot K, Rijnders A, et al. (2000) Differences in palliative radiotherapy for bone metastases within western european countries. Radiother Oncol 56: 297–303

    Article  PubMed  CAS  Google Scholar 

  8. Lievens Y, Van den BW, Rijnders A, et al. (2000) Palliative radiotherapy practice within western european countries: impact of the radiotherapy financing system? Radiother Oncol 56: 289–295

    Article  PubMed  CAS  Google Scholar 

  9. Steenland E, Leer JW, van Houwelingen H, et al. (1999) The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study. Radiother Oncol 52: 101–109

    Google Scholar 

  10. Chow E, Wu J, Hoskin P, et al. (2002) International consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases. Radiother Oncol 64: 275–280

    Article  PubMed  Google Scholar 

  11. Cole DJ (1989) A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clin Oncol (R Coll Radiol ) 1: 59–62

    CAS  Google Scholar 

  12. Gaze MN, Kelly CG, Kerr GR, et al. (1997) Pain relief and quality of life following radiotherapy for bone metastases: a randomised trial of two fractionation schedules. Radiother Oncol 45: 109–116

    Article  PubMed  CAS  Google Scholar 

  13. Hoskin PJ, Price P, Easton D, et al. (1992) A prospective randomised trial of 4\,Gy or 8\,Gy single doses in the treatment of metastatic bone pain. Radiother Oncol 23: 74–78

    Article  PubMed  CAS  Google Scholar 

  14. Madsen EL (1983) Painful bone metastasis: efficacy of radiotherapy assessed by the patients: a randomized trial comparing 4 Gy × 6 versus 10 Gy × 2. Int J Radiat Oncol Biol Phys 9: 1775–1779

    PubMed  CAS  Google Scholar 

  15. Nielsen OS, Bentzen SM, Sandberg E, et al. (1998) Randomized trial of single dose versus fractionated palliative radiotherapy of bone metastases. Radiother Oncol 47: 233–240

    Article  PubMed  CAS  Google Scholar 

  16. Niewald M, Tkocz HJ, Abel U, et al. (1996) Rapid course radiation therapy versus more standard treatment: a randomized trial for bone metastases. Int J Radiat Oncol Biol Phys 36: 1085–1089

    PubMed  CAS  Google Scholar 

  17. Okawa T, Kita M, Goto M, et al. (1988) Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases. Radiother Oncol 13: 99–104

    Article  PubMed  CAS  Google Scholar 

  18. Price P, Hoskin PJ, Easton D, et al. (1986) Prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases. Radiother Oncol 6: 247–255

    Article  PubMed  CAS  Google Scholar 

  19. Rasmusson B, Vejborg I, Jensen AB, et al. (1995) Irradiation of bone metastases in breast cancer patients: a randomized study with 1 year follow-up. Radiother Oncol 34: 179–184

    Article  PubMed  CAS  Google Scholar 

  20. Tong D, Gillick L, Hendrickson FR (1982) The palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group. Cancer 50: 893–899

    Article  PubMed  CAS  Google Scholar 

  21. Ratanatharathorn V, Powers WE, Moss WT, et al. (1999) Bone metastasis: review and critical analysis of random allocation trials of local field treatment [see comments]. Int J Radiat Oncol Biol Phys 44: 1–18

    Article  PubMed  CAS  Google Scholar 

  22. Blitzer PH (1985) Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis. Cancer 55: 1468–1472

    Article  PubMed  CAS  Google Scholar 

  23. McQuay HJ, Collins SL, Carroll D, et al. (2000) Radiotherapy for the palliation of painful bone metastases. Cochrane Database of Systematic Reviews 1999, Issue 3. Art. No.: CD001793. DOI: 10.1002/14651858. CD001793

    Google Scholar 

  24. Bone Pain Trial Working Party (1999) 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-up. Radiother Oncol 52: 111–121

    Google Scholar 

  25. Falkmer U, Jarhult J, Wersall P (2003) A systematic overview of radiation therapy effects in skeletal metastases. Acta Oncol 42: 620–633

    Article  PubMed  Google Scholar 

  26. Sze WM, Shelley MD, Held I, et al. (2003) Palliation of metastatic bone pain: single fraction versus mulifraction radiotherapy. A systematic review of randomised trials. Clin Oncol (R Coll Radiol) 15: 345–352

    CAS  Google Scholar 

  27. Hartsell WF, Scott CB, Bruner DW (2005) Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst 97: 798–804

    Article  PubMed  Google Scholar 

  28. Kaasaa S, Brenne E, Lundab JA (2006) Prospective randomised multicenter trial on single fraction radiotherapy (8 Gy × 1) versus multiple fractions (3 Gy × 10) in the treatment of painful bone metastases. Radiother Oncol 79: 278–284

    Article  Google Scholar 

  29. van der Linden YM, Lok JJ, Steenland E, et al. (2004) Single fraction radiotherapy is efficacious: a further analysis of the Dutch Bone Metastasis Study controlling for the influence of retreatment. Int J Radiat Oncol Biol Phys 59: 528–537

    PubMed  Google Scholar 

  30. van der Linden YM, Dijkstra PDS, Vonk EJA, et al. (2005) Prediction of survival in patients with metastases in the spinal column. Cancer 103: 320–328

    Article  PubMed  Google Scholar 

  31. Chow E, Davis L, Panzarella T (2005) Accuracy of survival prediction by palliative radiation oncologists. Int J Radiat Oncol Biol Phys 61: 870–873

    PubMed  Google Scholar 

  32. Hartsell W, Desilvio M, Watkins Bruner D (2008) Can physicians accurately predict survival time in patients with metastatic cancer? Analysis of RTOG 97-14. Palliat Med 11: 723–728

    Google Scholar 

  33. van der Linden YM, Steenland E, van Houwelingen H, et al. (2006) Patients with a favourable prognosis are equally palliated with single and multiple fraction radiotherapy: results on survival in the Dutch Bone Metastasis Study. Radiother Oncol 48: 245–253

    Google Scholar 

  34. Roos DE, Turner SL, O’Brien PC, et al. (2005) Randomized trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05). Radiother Oncol 75: 54–63

    Google Scholar 

  35. van der Linden Y, Leer JWH, Warlam-Rodenhuis CC (2007) Quality of life in patients with painful bone metastases participating in a randomized trial: a mixed model analysis on end-of-life issues. Int J Rad Onc Biol Phys 69:S31

    Google Scholar 

  36. Bruner D, Winter K, Hartsell W (2004) Prospective health-related quality of life valuations (utilities) of 8 Gy in 1 fraction versus 30 Gy in 10 fractions for palliation of painful bone metastases: preliminary results of RTOG 97–14. Int J Rad Onc Biol Phys 60:S142

    Article  Google Scholar 

  37. van der Linden YM, Kroon HM, Dijkstra PD, et al. (2003) Simple radiographic parameter predicts fracturing in metastatic femoral bone lesions: results from a randomized trial. Radiother Oncol 69: 21–31

    Article  PubMed  Google Scholar 

  38. van der Linden YM, Dijkstra PD, Kroon HM, et al. (2004) Comparative analysis of risk factors for pathological fracture with femoral metastases. Results based on a randomised trial of radiotherapy. J Bone Joint Surg Br 86-B: 566–573

    Google Scholar 

  39. Bartels RH, van der Linden YM, van der Graaf WT (2008) Spinal extradural metastasis: review of current treatment options. CA Cancer J Clin 58:245–259

    Article  PubMed  Google Scholar 

  40. Patchell R, Tibbs PA, Regine WF, et al. (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366: 643–648

    Article  PubMed  Google Scholar 

  41. van den Bent MJ (2005) Comment on: surgical resection improves outcome in metastastic epidrual spinal cord compression. Patchell et al. Lancet 366:643–648, Lancet 366: 609–610

    Google Scholar 

  42. Rades D, Veninga T, Stalpers LJ, et al. (2006) Prognostic factors predicting functional outcomes, recurrence-free survival, and overall survival after radiotherapy for metastatic spinal cord compression in breast cancer patients. Int J Radiat Oncol Biol Phys 64: 182–188

    PubMed  Google Scholar 

  43. Rades D, Heidenreich F, Karstens JH (2002) Final results of a prospective study of the prognostic value of the time to develop motor deficits before irradiation in metastatic spinal cord compression. Int J Radiat Oncol Biol Phys 53: 975–979

    PubMed  Google Scholar 

  44. Rades D, Rudat V, Veninga T (2008) A score predicting posttreatment ambulatory status in patients irradiated for metastatic spinal cord compression. Int J Radiat Oncol Biol Phys 72: 905–908

    PubMed  Google Scholar 

  45. Rades D, Lange M, Veninga T, et al. (2008) Preliminary results of spinal cord compression recurrence evaluation (score-1) study comparing short-course versus long-course radiotherapy for local control of malignant epidural spinal cord compression. Int J Rad Onc Biol Phys 73:228–234

    Google Scholar 

  46. Maranzano E, Trippa F, Casale M (2008) Single dose (8 Gy) versus short course (8 Gy × 2) radiotherapy in metastatic spinal cord compression: results of a phase III randomised multicentre trial. Radiother Oncol. 88:S139

    Google Scholar 

  47. Mithal NP, Needham PR, Hoskin PJ (1994) Retreatment with radiotherapy for painful bone metastases. Int J Radiat Oncol Biol Phys 29: 1011–1014

    PubMed  CAS  Google Scholar 

  48. Jeremic B, Shibamoto Y, Igrutinovic I (1999) Single 4 Gy re-irradiation for painful bone metastasis following single fraction radiotherapy. Radiother Oncol 52: 123–127

    Article  PubMed  CAS  Google Scholar 

  49. van Helvoirt R, Bratelli K (2008) Both immediate and late retreatment with single fraction radiotherapy are effective in palliating patients with painful skeletal metastases: a prospective cohort analysis. Radiother Oncol 88:S51

    Google Scholar 

  50. Chow E, Hoskin PJ, Wu J, et al. (2006) A phase III international randomised trial comparing single with multiple fractions for re-irradiation of painful bone metastases: National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) SC 20. Clin Oncol 18: 125–128

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, UMC St Radboud, Nijmegen, The Netherlands

    Jan W.H. Leer

  2. Radiotherapeutic Institute Friesland, Borniastraat 36, 8934 AD, Leeuwarden, The Netherlands

    M. Yvette van der Linden

Authors
  1. Jan W.H. Leer
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  2. M. Yvette van der Linden
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Corresponding author

Correspondence to Jan W.H. Leer .

Editor information

Editors and Affiliations

  1. Dept. of Radiation Oncology, University of Patras Medical School, 265 04, Patras, Greece

    Dimitrios Kardamakis MD, PhD, DMRT  & Vassilios Vassiliou MD, PhD  & 

  2. Dept. of Radiation Oncology, University of Toronto Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada

    Edward Chow MBBS, PhD, FRCPC

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Leer, J.W., van der Linden, Y. (2009). Radiotherapy And Bone Metastases. In: Kardamakis, D., Vassiliou, V., Chow, E. (eds) Bone Metastases. Cancer Metastasis – Biology and Treatment, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9819-2_9

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