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Current Approaches in Bone Metastasis Radiotherapy

Yıl 2024, Cilt: 19 Sayı: 3, 167 - 173, 04.11.2024
https://doi.org/10.17517/ksutfd.1475932

Öz

Bone metastases comprise a significant portion of the areas where palliative radiotherapy is applied. Radiotherapy can be easily used for uncomplicated painful bone lesions without serious side effects. However, complicated bone metastases should be evaluated surgically before radiotherapy. Metastatic Spinal Cord Compression, included in this group, is among the oncological emergencies. If the patient cannot be operated on, radiotherapy should be given urgently. Increasing life spans also increase the need for radiation therapy in the same area again. In case of re-irradiation to bone metastases, special attention should be given to the tolerance doses of normal tissues, especially the spinal cord. Radiotherapy has become an effective and reliable treatment method in the treatment of bone metastases, both for the first time and re-irradiation cases, with current technological developments.

Kaynakça

  • Mundy GR. Metastasis to bone: causes, consequences and therapeutic opportunities. Nature reviews Cancer. 2002;2(8):584-93. Epub 2002/08/03. doi: 10.1038/nrc867. PubMed PMID: 12154351.
  • Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM, Verkooijen HM. Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. International journal of radiation oncology, biology, physics. 2012;84(1):8-14. Epub 2012/02/04. doi: 10.1016/j.ijrobp.2011.10.080. PubMed PMID: 22300568.
  • Kuzhan A, Adli M. The role of FDG uptake to predict the need for re-irradiation in patients treated with 8 Gy (X-ray) single fraction palliative radiotherapy for bone metastases. International Journal of Radiation Research. 2023;21(4):693-8.
  • Chow E, Zeng L, Salvo N, Dennis K, Tsao M, Lutz S. Update on the systematic review of palliative radiotherapy trials for bone metastases. Clinical oncology. 2012;24(2):112-24.
  • Brodowicz T, Hadji P, Niepel D, Diel I. Early identification and intervention matters: a comprehensive review of current evidence and recommendations for the monitoring of bone health in patients with cancer. Cancer treatment reviews. 2017;61:23-34.
  • Novello S, Barlesi F, Califano R, Cufer T, Ekman S, Levra MG, et al. Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2016;27:v1-v27.
  • van der Velden J, Willmann J, Spałek M, Oldenburger E, Brown S, Kazmierska J, et al. ESTRO ACROP guidelines for external beam radiotherapy of patients with uncomplicated bone metastases. Radiotherapy and Oncology. 2022;173:197-206.
  • Oldenburger E, Brown S, Willmann J, van der Velden JM, Spałek M, van der Linden YM, et al. ESTRO ACROP guidelines for external beam radiotherapy of patients with complicated bone metastases. Radiotherapy and Oncology. 2022;173:240-53.
  • Cole JS, Patchell RA. Metastatic epidural spinal cord compression. The Lancet Neurology. 2008;7(5):459-66.
  • Prasad D, Schiff D. Malignant spinal-cord compression. The lancet oncology. 2005;6(1):15-24.
  • Loblaw D, Laperriere N, Mackillop W. A population-based study of malignant spinal cord compression in Ontario. Clinical oncology. 2003;15(4):211-7.
  • Gold M. Magnetic resonance imaging of spinal emergencies. Topics in Magnetic Resonance Imaging. 2015;24(6):325-30.
  • Bilsky MH, Laufer I, Fourney DR, Groff M, Schmidt MH, Varga PP, et al. Reliability analysis of the epidural spinal cord compression scale. Journal of Neurosurgery: Spine. 2010;13(3):324-8.
  • Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, et al. The NOMS framework: approach to the treatment of spinal metastatic tumors. The oncologist. 2013;18(6):744-51.
  • MacLean MA, Touchette CJ, Georgiopoulos M, Brunette-Clément T, Abduljabbar FH, Ames CP, et al. Systemic considerations for the surgical treatment of spinal metastatic disease: a scoping literature review. The Lancet Oncology. 2022;23(7):e321-e33.
  • Guckenberger M, Hawkins M, Flentje M, Sweeney RA. Fractionated radiosurgery for painful spinal metastases: DOSIS-a phase II trial. BMC cancer. 2012;12:1-9.
  • Buergy D, Siedlitzki L, Boda-Heggemann J, Wenz F, Lohr F. Overall survival after reirradiation of spinal metastases–independent validation of predictive models. Radiation Oncology. 2016;11:1-7.
  • Nieder C, Andratschke N, Angelo K, Haukland E, Grosu AL. Development of a score predicting survival after palliative reirradiation. Journal of oncology. 2014;2014.
  • Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM, Verkooijen HM. Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. International Journal of Radiation Oncology* Biology* Physics. 2012;84(1):8-14.
  • Chow E, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JS, et al. Single versus multiple fractions of repeat radiation for painful bone metastases: a randomised, controlled, non-inferiority trial. The Lancet Oncology. 2014;15(2):164-71.
  • van der Linden YM, Kroon HM, Dijkstra SP, Lok JJ, Noordijk EM, Leer JWH, et al. Simple radiographic parameter predicts fracturing in metastatic femoral bone lesions: results from a randomised trial. Radiotherapy and Oncology. 2003;69(1):21-31.
  • Shimoyama T, Katagiri H, Harada H, Murata H, Wasa J, Hosaka S, et al. Fracture after radiation therapy for femoral metastasis: incidence, timing and clinical features. Journal of Radiation Research. 2017;58(5):661-8.
  • Tatar Z, Soubrier M, Dillies AF, Verrelle P, Boisgard S, Lapeyre M. Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan-based virtual simulation: a retrospective study. Radiation oncology. 2014;9:1-10.
  • Maranzano E, Trippa F, Casale M, Anselmo P, Rossi R. Reirradiation of metastatic spinal cord compression: definitive results of two randomized trials. Radiotherapy and oncology. 2011;98(2):234-7.
  • Rades D, Stalpers LJ, Veninga T, Hoskin PJ. Spinal reirradiation after short-course RT for metastatic spinal cord compression. International Journal of Radiation Oncology* Biology* Physics. 2005;63(3):872-5.
  • Kirkpatrick JP, Van Der Kogel AJ, Schultheiss TE. Radiation dose–volume effects in the spinal cord. International Journal of Radiation Oncology* Biology* Physics. 2010;76(3):S42-S9.
  • Langendijk JA, Kasperts N, Leemans CR, Doornaert P, Slotman BJ. A phase II study of primary reirradiation in squamous cell carcinoma of head and neck. Radiotherapy and oncology. 2006;78(3):306-12.
  • Nieder C, Grosu AL, Andratschke NH, Molls M. Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. International Journal of Radiation Oncology* Biology* Physics. 2006;66(5):1446-9.
  • Sahgal A, Myrehaug S, Siva S, Masucci L, Foote M, Brundage M, et al. CCTG SC. 24/TROG 17.06: A randomized phase II/III study comparing 24Gy in 2 stereotactic body radiotherapy (SBRT) fractions versus 20Gy in 5 conventional palliative radiotherapy (CRT) fractions for patients with painful spinal metastases. International journal of radiation oncology, biology, physics. 2020;108(5):1397-8.
  • Ryu S, Deshmukh S, Timmerman RD, Movsas B, Gerszten P, Yin F-F, et al. Stereotactic radiosurgery vs conventional radiotherapy for localized vertebral metastases of the spine: phase 3 results of NRG Oncology/RTOG 0631 randomized clinical trial. JAMA oncology. 2023;9(6):800-7.
  • Pielkenrood BJ, van der Velden JM, van der Linden YM, Bartels MM, Kasperts N, Verhoeff JJ, et al. Pain response after stereotactic body radiation therapy versus conventional radiation therapy in patients with bone metastases—a phase 2 randomized controlled trial within a prospective cohort. International Journal of Radiation Oncology* Biology* Physics. 2021;110(2):358-67.
  • Sprave T, Verma V, Förster R, Schlampp I, Bruckner T, Bostel T, et al. Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiotherapy and Oncology. 2018;128(2):274-82.
  • Mercier C, Billiet C, De Kerf G, Vandecasteele K, Ost P, Joye I, et al. OC-0762 Single fraction SBRT vs 3D-CRT for painful bone metastases: a single-blind phase 3 RCT (NCT03831243). Radiotherapy and Oncology. 2023;182:S628-S9.
  • Cox BW, Spratt DE, Lovelock M, Bilsky MH, Lis E, Ryu S, et al. International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. International Journal of Radiation Oncology* Biology* Physics. 2012;83(5):e597-e605.
  • Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M, et al. ESTRO clinical practice guideline: Stereotactic Body Radiotherapy for Spine metastases. Elsevier; 2023. p. 109966.
  • Zeng KL, Myrehaug S, Soliman H, Husain ZA, Tseng C-L, Detsky J, et al. Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy. International Journal of Radiation Oncology* Biology* Physics. 2022;114(2):293-300.

Kemik Metastazı Radyoterapisinde Güncel Yaklaşımlar

Yıl 2024, Cilt: 19 Sayı: 3, 167 - 173, 04.11.2024
https://doi.org/10.17517/ksutfd.1475932

Öz

Kemik metastazları, palyatif radyoterapi yapılan bölgelerin önemli bir kısmını oluşturmaktadır. Radyoterapi, komplike olmayan ağrılı lezyonlar için ciddi bir yan etki olmaksızın kolaylıkla uygulanabilir. Fakat komplike kemik metastazları, radyoterapi öncesi cerrahi açıdan değerlendirilmelidir. Bu grupta yer alan ve onkolojik aciller arasında olan Metastatik Spinal Kord Kompresyonunda, hasta opere olamayacaksa acil radyoterapi uygulanmalıdır. Artan yaşam süreleri aynı alana yeniden radyoterapi ihtiyacını da artırmaktadır. Yeniden ışınlama yapılması gereken durumlarda da özellikle spinal kord gibi normal dokuların tolerans dozlarına çok dikkat edilmelidir. Radyoterapi, güncel teknolojik gelişmeler sayesinde, kemik metastazlarının tedavisinde hem ilk kez hem de yeniden ışınlama durumlarında etkili ve güvenilir bir tedavi yöntemi haline gelmiştir.

Kaynakça

  • Mundy GR. Metastasis to bone: causes, consequences and therapeutic opportunities. Nature reviews Cancer. 2002;2(8):584-93. Epub 2002/08/03. doi: 10.1038/nrc867. PubMed PMID: 12154351.
  • Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM, Verkooijen HM. Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. International journal of radiation oncology, biology, physics. 2012;84(1):8-14. Epub 2012/02/04. doi: 10.1016/j.ijrobp.2011.10.080. PubMed PMID: 22300568.
  • Kuzhan A, Adli M. The role of FDG uptake to predict the need for re-irradiation in patients treated with 8 Gy (X-ray) single fraction palliative radiotherapy for bone metastases. International Journal of Radiation Research. 2023;21(4):693-8.
  • Chow E, Zeng L, Salvo N, Dennis K, Tsao M, Lutz S. Update on the systematic review of palliative radiotherapy trials for bone metastases. Clinical oncology. 2012;24(2):112-24.
  • Brodowicz T, Hadji P, Niepel D, Diel I. Early identification and intervention matters: a comprehensive review of current evidence and recommendations for the monitoring of bone health in patients with cancer. Cancer treatment reviews. 2017;61:23-34.
  • Novello S, Barlesi F, Califano R, Cufer T, Ekman S, Levra MG, et al. Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2016;27:v1-v27.
  • van der Velden J, Willmann J, Spałek M, Oldenburger E, Brown S, Kazmierska J, et al. ESTRO ACROP guidelines for external beam radiotherapy of patients with uncomplicated bone metastases. Radiotherapy and Oncology. 2022;173:197-206.
  • Oldenburger E, Brown S, Willmann J, van der Velden JM, Spałek M, van der Linden YM, et al. ESTRO ACROP guidelines for external beam radiotherapy of patients with complicated bone metastases. Radiotherapy and Oncology. 2022;173:240-53.
  • Cole JS, Patchell RA. Metastatic epidural spinal cord compression. The Lancet Neurology. 2008;7(5):459-66.
  • Prasad D, Schiff D. Malignant spinal-cord compression. The lancet oncology. 2005;6(1):15-24.
  • Loblaw D, Laperriere N, Mackillop W. A population-based study of malignant spinal cord compression in Ontario. Clinical oncology. 2003;15(4):211-7.
  • Gold M. Magnetic resonance imaging of spinal emergencies. Topics in Magnetic Resonance Imaging. 2015;24(6):325-30.
  • Bilsky MH, Laufer I, Fourney DR, Groff M, Schmidt MH, Varga PP, et al. Reliability analysis of the epidural spinal cord compression scale. Journal of Neurosurgery: Spine. 2010;13(3):324-8.
  • Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, et al. The NOMS framework: approach to the treatment of spinal metastatic tumors. The oncologist. 2013;18(6):744-51.
  • MacLean MA, Touchette CJ, Georgiopoulos M, Brunette-Clément T, Abduljabbar FH, Ames CP, et al. Systemic considerations for the surgical treatment of spinal metastatic disease: a scoping literature review. The Lancet Oncology. 2022;23(7):e321-e33.
  • Guckenberger M, Hawkins M, Flentje M, Sweeney RA. Fractionated radiosurgery for painful spinal metastases: DOSIS-a phase II trial. BMC cancer. 2012;12:1-9.
  • Buergy D, Siedlitzki L, Boda-Heggemann J, Wenz F, Lohr F. Overall survival after reirradiation of spinal metastases–independent validation of predictive models. Radiation Oncology. 2016;11:1-7.
  • Nieder C, Andratschke N, Angelo K, Haukland E, Grosu AL. Development of a score predicting survival after palliative reirradiation. Journal of oncology. 2014;2014.
  • Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM, Verkooijen HM. Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. International Journal of Radiation Oncology* Biology* Physics. 2012;84(1):8-14.
  • Chow E, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JS, et al. Single versus multiple fractions of repeat radiation for painful bone metastases: a randomised, controlled, non-inferiority trial. The Lancet Oncology. 2014;15(2):164-71.
  • van der Linden YM, Kroon HM, Dijkstra SP, Lok JJ, Noordijk EM, Leer JWH, et al. Simple radiographic parameter predicts fracturing in metastatic femoral bone lesions: results from a randomised trial. Radiotherapy and Oncology. 2003;69(1):21-31.
  • Shimoyama T, Katagiri H, Harada H, Murata H, Wasa J, Hosaka S, et al. Fracture after radiation therapy for femoral metastasis: incidence, timing and clinical features. Journal of Radiation Research. 2017;58(5):661-8.
  • Tatar Z, Soubrier M, Dillies AF, Verrelle P, Boisgard S, Lapeyre M. Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan-based virtual simulation: a retrospective study. Radiation oncology. 2014;9:1-10.
  • Maranzano E, Trippa F, Casale M, Anselmo P, Rossi R. Reirradiation of metastatic spinal cord compression: definitive results of two randomized trials. Radiotherapy and oncology. 2011;98(2):234-7.
  • Rades D, Stalpers LJ, Veninga T, Hoskin PJ. Spinal reirradiation after short-course RT for metastatic spinal cord compression. International Journal of Radiation Oncology* Biology* Physics. 2005;63(3):872-5.
  • Kirkpatrick JP, Van Der Kogel AJ, Schultheiss TE. Radiation dose–volume effects in the spinal cord. International Journal of Radiation Oncology* Biology* Physics. 2010;76(3):S42-S9.
  • Langendijk JA, Kasperts N, Leemans CR, Doornaert P, Slotman BJ. A phase II study of primary reirradiation in squamous cell carcinoma of head and neck. Radiotherapy and oncology. 2006;78(3):306-12.
  • Nieder C, Grosu AL, Andratschke NH, Molls M. Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. International Journal of Radiation Oncology* Biology* Physics. 2006;66(5):1446-9.
  • Sahgal A, Myrehaug S, Siva S, Masucci L, Foote M, Brundage M, et al. CCTG SC. 24/TROG 17.06: A randomized phase II/III study comparing 24Gy in 2 stereotactic body radiotherapy (SBRT) fractions versus 20Gy in 5 conventional palliative radiotherapy (CRT) fractions for patients with painful spinal metastases. International journal of radiation oncology, biology, physics. 2020;108(5):1397-8.
  • Ryu S, Deshmukh S, Timmerman RD, Movsas B, Gerszten P, Yin F-F, et al. Stereotactic radiosurgery vs conventional radiotherapy for localized vertebral metastases of the spine: phase 3 results of NRG Oncology/RTOG 0631 randomized clinical trial. JAMA oncology. 2023;9(6):800-7.
  • Pielkenrood BJ, van der Velden JM, van der Linden YM, Bartels MM, Kasperts N, Verhoeff JJ, et al. Pain response after stereotactic body radiation therapy versus conventional radiation therapy in patients with bone metastases—a phase 2 randomized controlled trial within a prospective cohort. International Journal of Radiation Oncology* Biology* Physics. 2021;110(2):358-67.
  • Sprave T, Verma V, Förster R, Schlampp I, Bruckner T, Bostel T, et al. Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiotherapy and Oncology. 2018;128(2):274-82.
  • Mercier C, Billiet C, De Kerf G, Vandecasteele K, Ost P, Joye I, et al. OC-0762 Single fraction SBRT vs 3D-CRT for painful bone metastases: a single-blind phase 3 RCT (NCT03831243). Radiotherapy and Oncology. 2023;182:S628-S9.
  • Cox BW, Spratt DE, Lovelock M, Bilsky MH, Lis E, Ryu S, et al. International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. International Journal of Radiation Oncology* Biology* Physics. 2012;83(5):e597-e605.
  • Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M, et al. ESTRO clinical practice guideline: Stereotactic Body Radiotherapy for Spine metastases. Elsevier; 2023. p. 109966.
  • Zeng KL, Myrehaug S, Soliman H, Husain ZA, Tseng C-L, Detsky J, et al. Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy. International Journal of Radiation Oncology* Biology* Physics. 2022;114(2):293-300.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Derlemeler
Yazarlar

Neslihan Kurtul 0000-0001-9173-6280

Erken Görünüm Tarihi 23 Ekim 2024
Yayımlanma Tarihi 4 Kasım 2024
Gönderilme Tarihi 30 Nisan 2024
Kabul Tarihi 10 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 19 Sayı: 3

Kaynak Göster

AMA Kurtul N. Kemik Metastazı Radyoterapisinde Güncel Yaklaşımlar. KSÜ Tıp Fak Der. Kasım 2024;19(3):167-173. doi:10.17517/ksutfd.1475932