BACKGROUND AND PURPOSE: The aim of this study was to compare the need for re-irradiation, rates of pathological fractures, and spinal cord compressions in patients randomised to single-fraction radiotherapy (8 Gy x 1) or multiple-fraction therapy (3 Gy x 10) and with a long-term follow-up. The underlying hypothesis was that single-fraction and multiple-fraction regimens are equally effective. MATERIAL AND METHODS: The present study reports on the Norwegian sub sample of an international large prospective-randomised multicentre study. One hundred and eighty patients with painful skeletal metastases in four Norwegian hospitals were randomised to receive single-fraction (8 Gy x 1) or multiple-fraction (3 Gy x 10) radiotherapy. RESULTS: Patients in the single-fraction arm received significantly more re-irradiations as compared to the multiple-fraction arm (27% versus 9%, p=0.002). There were no significant differences in the rate of pathological fractures (5% versus 5%, p=1.00) or spinal cord compressions (1% versus 4%, p=0.37) between the two treatment groups. CONCLUSION: The present study indicates no difference between radiotherapy with 8 Gy x 1 and 3 Gy x 10 for the majority of patients with painful bone metastases, also in a long-term perspective. Importantly, the patients in this study were followed up until death, and the trial showed no disadvantage for 8 Gy x 1 compared to 3 Gy x 10. Despite the fact that single-fraction treatment will imply an approximately 2.5-fold greater need for re-irradiation, single-fraction treatment is considered more convenient for the patients and more cost-effective for the radiotherapy departments.
RCT Entities:
BACKGROUND AND PURPOSE: The aim of this study was to compare the need for re-irradiation, rates of pathological fractures, and spinal cord compressions in patients randomised to single-fraction radiotherapy (8 Gy x 1) or multiple-fraction therapy (3 Gy x 10) and with a long-term follow-up. The underlying hypothesis was that single-fraction and multiple-fraction regimens are equally effective. MATERIAL AND METHODS: The present study reports on the Norwegian sub sample of an international large prospective-randomised multicentre study. One hundred and eighty patients with painful skeletal metastases in four Norwegian hospitals were randomised to receive single-fraction (8 Gy x 1) or multiple-fraction (3 Gy x 10) radiotherapy. RESULTS:Patients in the single-fraction arm received significantly more re-irradiations as compared to the multiple-fraction arm (27% versus 9%, p=0.002). There were no significant differences in the rate of pathological fractures (5% versus 5%, p=1.00) or spinal cord compressions (1% versus 4%, p=0.37) between the two treatment groups. CONCLUSION: The present study indicates no difference between radiotherapy with 8 Gy x 1 and 3 Gy x 10 for the majority of patients with painful bone metastases, also in a long-term perspective. Importantly, the patients in this study were followed up until death, and the trial showed no disadvantage for 8 Gy x 1 compared to 3 Gy x 10. Despite the fact that single-fraction treatment will imply an approximately 2.5-fold greater need for re-irradiation, single-fraction treatment is considered more convenient for the patients and more cost-effective for the radiotherapy departments.
Authors: Lucia Gutiérrez Bayard; María Del Carmen Salas Buzón; Esther Angulo Paín; Lourdes de Ingunza Barón Journal: Rep Pract Oncol Radiother Date: 2014-05-06
Authors: Sara R Alcorn; Christen R Elledge; Jean L Wright; Thomas J Smith; Todd R McNutt; Jacob Fiksel; Scott L Zeger; Theodore L DeWeese Journal: Int J Radiat Oncol Biol Phys Date: 2019-12-02 Impact factor: 7.038
Authors: Anne M Walling; Phillip J Beron; Tania Kaprealian; Patrick A Kupelian; Neil S Wenger; Susan A McCloskey; Christopher R King; Michael Steinberg Journal: J Palliat Med Date: 2017-02-23 Impact factor: 2.947
Authors: Quynh-Nhu Nguyen; Stephen G Chun; Edward Chow; Ritsuko Komaki; Zhongxing Liao; Rensi Zacharia; Bill K Szeto; James W Welsh; Stephen M Hahn; C David Fuller; Bryan S Moon; Justin E Bird; Robert Satcher; Patrick P Lin; Melenda Jeter; Michael S O'Reilly; Valerae O Lewis Journal: JAMA Oncol Date: 2019-06-01 Impact factor: 31.777