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Clinical & Experimental Metastasis

, Volume 35, Issue 8, pp 747–752 | Cite as

Efficacy and safety of 3D-conformal half body irradiation in patients with multiple bone metastases

  • Gabriella Macchia
  • Milena Ferro
  • Savino Cilla
  • Milly Buwenge
  • Anna Ianiro
  • Mariangela Boccardi
  • Vincenzo Picardi
  • Marica Ferro
  • Eleonora Arena
  • Alice Zamagni
  • Silvia Cammelli
  • Vincenzo Valentini
  • Alessio G. Morganti
  • Francesco Deodato
Research Paper
  • 64 Downloads

Abstract

Half-body irradiation (HBI) represented a standard treatment for multiple painful bone metastases (BMs). However, its use has progressively reduced due to the associated toxicity rates. The aim of this paper was to evaluate HBI delivered by conformal radiotherapy (RT) technique in a large patients population with widespread BMs. HBI was delivered in 3 Gy fractions, bid, ≥ 6 h apart, on 2 consecutive days (total dose: 12 Gy) using 3-dimensional conformal RT (3D-CRT) box technique. The target included pelvic bones, lumbar-sacral vertebrae and upper third of femurs. Acute and late toxicity was scored based on RTOG and EORTC–RTOG scales, respectively. Pain was evaluated using the Pain-Drug scores and the Visual Analog Scale (VAS). One hundred and eighty patients were eligible for inclusion in this retrospective analysis. Grade 3 and 4 acute toxicity rates were 1.1% and 0.0%, respectively. Mean VAS before and after HBI was 5.3 versus 2.7, respectively (p: 0.0001). Based on VAS, 37.5% of patients showed complete pain relief (VAS: 0) while 38.1% had partial response (≥ 2-point VAS reduction). Overall, Pain and Drug Score reduction was observed in 76.3% and 50.4% of patients, respectively. 1-, 2-, and 3-year pain progression free survival was 77.0%, 63.4%, and 52.7%, respectively. Thirty patients (16.7%) underwent RT retreatment on the same site with median 15.9 months interval (range 2–126 months). HBI delivered with 3D-CRT technique is safe and effective. It provides long lasting pain control in patients with multiple BMs with negligible rates of relevant toxicity.

Keywords

Radiotherapy Bone metastases Half body irradiation 3D-conformal 

Abbreviations

HBI

Half-body irradiation

BMs

Bone metastases (BMs)

RT

Radiotherapy

3D-CRT

3-dimensional conformal RT

VAS

Visual Analog Scale

QoL

Quality of life

IAEA

International Atomic Energy Agency

2D

Two-dimensional

CT

Computed tomography scan

MRI

Magnetic resonance imaging

CTV

Clinical target volume

EQD2

Equivalent dose in 2 Gy/fraction

PTV

Planning target volume

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Gabriella Macchia
    • 1
  • Milena Ferro
    • 1
  • Savino Cilla
    • 2
  • Milly Buwenge
    • 3
  • Anna Ianiro
    • 2
  • Mariangela Boccardi
    • 1
  • Vincenzo Picardi
    • 1
  • Marica Ferro
    • 1
  • Eleonora Arena
    • 1
  • Alice Zamagni
    • 3
  • Silvia Cammelli
    • 3
  • Vincenzo Valentini
    • 4
  • Alessio G. Morganti
    • 3
  • Francesco Deodato
    • 1
  1. 1.Radiotherapy Unit, “Giovanni Paolo II” FoundationCatholic University of Sacred HeartCampobassoItaly
  2. 2.Medical Physics Unit, “Giovanni Paolo II” FoundationCatholic University of Sacred HeartCampobassoItaly
  3. 3.Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine - DIMESUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  4. 4.Radiotherapy Department, Policlinico Universitario “A. Gemelli”Catholic University of Sacred HeartRomeItaly

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