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Treatment outcomes of stereotactic ablative radiation therapy for non-spinal bone metastases: focus on response assessment and treatment indication

Title
Treatment outcomes of stereotactic ablative radiation therapy for non-spinal bone metastases: focus on response assessment and treatment indication
Authors
Yu, TosolChoi, Chul-WonKim, Kyung Su
Ewha Authors
김경수
Issue Date
2019
Journal Title
BRITISH JOURNAL OF RADIOLOGY
ISSN
0007-1285JCR Link

1748-880XJCR Link
Citation
BRITISH JOURNAL OF RADIOLOGY vol. 92, no. 1099
Publisher
BRITISH INST RADIOLOGY
Indexed
SCI; SCIE; SCOPUS WOS
Document Type
Article
Abstract
Objective: To report treatment outcomes of stereotactic ablative radiation therapy (SABR) for non-spinal bone metastases in a single institution, and to compare assessments of Response Evaluation Criteria in Solid Tumors (RECIST) v. 1.1 and the University of Texas MD Anderson Cancer Center (MDA) criteria. Methods: From July 2011 to January 2017, 33 patients with 38 non-spinal bone metastatic lesions were treated using SABR. Treatment intent was categorized as follows: single metastasis or oligo-metastases; oligo-progression; and dominant areas of progression. Tumor responses were evaluated according to the RECIST and MDA criteria. Local control (LC) was defined as lesions that were not classified as progressive disease on both criteria. Results: The median follow-up period was 10.4 months (range, 2.5-47.4). Both 1- and 2year LC rates were 94.2 %. The median overall survival (OS) was 20.2 months, and the median progression-free survival (PFS) was 6.9 months. Treatment intent was a significant factor for OS in multivariate analysis. The lyear OS rates for single metastasis or oligo-metastasis, for oligo-progression, and for dominant areas of progression were 84.2%, 66.7%, and 0.0%, respectively ( p < 0.001). Overall response rate was 86.8 % according to MDA criteria, and 75.7 % according to RECIST criteria. When using MDA criteria, there appeared to be significant associations both between response and PFS (median 7.6 months for responders vs 2.5 months for non-responders: p = 0.036) and between response and OS. In contrast, when using RECIST criteria, the associations were significant neither between response and PFS (median 5.8 months for responders vs 9.3 months for non-responders; p = 0.522) nor between response and OS (25.7 months for responders vs 18.5 months for non-responders; p = 0.811). Conclusion: SABR for non-spinal bone metastases demonstrated high LC rates with acceptable toxicity. The MDA criteria demonstrated advantages in predicting survival outcomes. Advances In knowledge: SABR for non-spinal bone metastases is a promising treatment option to achieve good local control. The MDA criteria, which is a newly proposed response evaluation criteria for bone metastases, has advantages in predicting survival outcomes compared to other established criteria.
DOI
10.1259/bjr.20181048
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의료원 > 의료원 > Journal papers
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