Clinical outcome of patients treated with re-irradiation for spine or pelvic bone metastasis: A multi-institutional analysis of 98 patients

Suzuki,Gen; Yamazaki,Hideya; Aibe,Norihiro; Masui,Koji; Kimoto,Takuya; Tatekawa,Kotoha; Nakashima,Akinori; Takenaka,Tadashi; Nishimura,Takeshi; Sasaki,Naomi; Oh,Ryoong-Jin; Konishi,Koji; Okabe,Haruumi; Nagasawa,Shinsuke; Yamada,Kei

doi:10.3892/mco.2017.1245

Clinical outcome of patients treated with re-irradiation for spine or pelvic bone metastasis: A multi-institutional analysis of 98 patients

Authors:
- Gen Suzuki
- Hideya Yamazaki
- Norihiro Aibe
- Koji Masui
- Takuya Kimoto
- Kotoha Tatekawa
- Akinori Nakashima
- Tadashi Takenaka
- Takeshi Nishimura
- Naomi Sasaki
- Ryoong-Jin Oh
- Koji Konishi
- Haruumi Okabe
- Shinsuke Nagasawa
- Kei Yamada
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Affiliations: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602‑8566, Japan, Department of Radiology, Miyakojima iGRT Clinic, Osaka 534-0021, Japan, Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-0025, Japan, Department of Radiology, Uji Takeda Hospital, Uji 611-0021, Japan, Department of Radiology, Saiseikai Shigaken Hospital, Ritto 520-3240, Japan
Published online on: May 8, 2017 https://doi.org/10.3892/mco.2017.1245
Pages: 871-875
Copyright: © Suzuki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to describe the clinical results of re-irradiation (Re-RT) for spine or pelvic bone metastasis at the same initial irradiated area. Between April 2010 and March 2014, cases involving 98 patients with spine or pelvic bone metastasis who had undergone Re-RT at five institutions were reviewed. The clinical outcomes following Re-RT were evaluated, including overall survival (OS) and severe adverse events. The median time interval from initial radiation therapy (RT) to Re-RT was 439 days (range, 23-4,993 days), and the median duration of patient follow-up was 256 days (range, 11-2,284 days). The median biological effective dose for the Re-RT was 150 Gy2 (range, 17-240 Gy2; α/β = 2). Severe late adverse events occurred in two patients who underwent three-dimensional conformal radiotherapy for lumbar spine or pelvic bone metastases, which may be associated with tumor progression. The median survival time following Re-RT was 255 days, and the actuarial OS rate at 1 year was 36%. The interval between initial RT and Re-RT, and their performance statuses (PS) were significant independent prognostic factors for OS rates in multivariate analysis. Re-RT for spine or pelvic bone metastases is a relatively acceptable option with low risk of anticipated severe adverse events, particularly for patients with good PS following a long disease-free interval.

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1	Lutz S, Berk L, Chang E, Chow E, Hahn C, Hoskin P, Howell D, Konski A, Kachnic L, Lo S, et al: American Society for Radiation Oncology (ASTRO): Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys. 79:965–976. 2011. View Article : Google Scholar : PubMed/NCBI
2	Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM and Verkooijen HM: Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. Int J Radiat Oncol Biol Phys. 84:8–14. 2012. View Article : Google Scholar : PubMed/NCBI
3	Hayashi S, Hoshi H and Iida T: Reirradiation with local-field radiotherapy for painful bone metastases. Radiat Med. 20:231–236. 2002.PubMed/NCBI
4	Jeremic B, Shibamoto Y and Igrutinovic I: Single 4 Gy re-irradiation for painful bone metastasis following single fraction radiotherapy. Radiother Oncol. 52:123–127. 1999. View Article : Google Scholar : PubMed/NCBI
5	Mithal NP, Needham PR and Hoskin PJ: Retreatment with radiotherapy for painful bone metastases. Int J Radiat Oncol Biol Phys. 29:1011–1014. 1994. View Article : Google Scholar : PubMed/NCBI
6	van der Linden YM, Lok JJ, Steenland E, Martijn H, van Houwelingen H, Marijnen CA and Leer JW; Dutch Bone Metastasis Study Group, : 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. 2004. View Article : Google Scholar : PubMed/NCBI
7	Wong E, Hoskin P, Bedard G, Poon M, Zeng L, Lam H, Vulpe H, Tsao M, Pulenzas N and Chow E: Re-irradiation for painful bone metastases - a systematic review. Radiother Oncol. 110:61–70. 2014. View Article : Google Scholar : PubMed/NCBI
8	National Cancer Institute, . Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm#ctc_40January 8–2016
9	Nieder C, Grosu AL, Andratschke NH and Molls M: Proposal of human spinal cord reirradiation dose based on collection of data from 40 patients. Int J Radiat Oncol Biol Phys. 61:851–855. 2005. View Article : Google Scholar : PubMed/NCBI
10	Nieder C, Grosu AL, Andratschke NH and Molls M: Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys. 66:1446–1449. 2006. View Article : Google Scholar : PubMed/NCBI
11	Kawashiro S, Harada H, Katagiri H, Asakura H, Ogawa H, Onoe T, Sumita K, Murayama S, Murata H, Nemoto K, et al: Reirradiation of spinal metastases with intensity-modulated radiation therapy: an analysis of 23 patients. J Radiat Res (Tokyo). 57:150–156. 2016. View Article : Google Scholar
12	Jereczek-Fossa BA, Kowalczyk A, DOnofrio A, Catalano G, Garibaldi C, Boboc G, Vitolo V, Leonardi MC, Cambria R and Orecchia R: Three-dimensional conformal or stereotactic reirradiation of recurrent, metastatic or new primary tumors. Analysis of 108 patients. Strahlenther Onkol. 184:36–40. 2008. View Article : Google Scholar : PubMed/NCBI
13	Hernanz R, Montero A, Fernandez-Lizarbe E, Polo A and Ramos A: Retreatment with radiotherapy for symptomatic bone, brain or visceral metastases. Clin Transl Oncol. 15:72–78. 2013. View Article : Google Scholar : PubMed/NCBI
14	Hashmi A, Guckenberger M, Kersh R, Gerszten PC, Mantel F, Grills IS, Flickinger JC, Shin JH, Fahim DK, Winey B, et al: Re-irradiation stereotactic body radiotherapy for spinal metastases: a multi-institutional outcome analysis. J Neurosurg Spine. 25:646–653. 2016. View Article : Google Scholar : PubMed/NCBI
15	Damast S, Wright J, Bilsky M, Hsu M, Zhang Z, Lovelock M, Cox B, Zatcky J and Yamada Y: Impact of dose on local failure rates after image-guided reirradiation of recurrent paraspinal metastases. Int J Radiat Oncol Biol Phys. 81:819–826. 2011. View Article : Google Scholar : PubMed/NCBI
16	Wong CS, van Dyk J, Milosevic M and Laperriere NJ: Radiation myelopathy following single courses of radiotherapy and retreatment. Int J Radiat Oncol Biol Phys. 30:575–581. 1994. View Article : Google Scholar : PubMed/NCBI