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Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms

PURPOSE: Bone metastases are reported in 10% to 12% of patients with neuroendocrine neoplasms (NENs) and can lead to pain and skeletal-related events (SREs), resulting in diminished quality of life and functional status. In other solid tumors with bone metastases, radiation therapy (RT) is an establ...

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Autores principales: Guan, Michelle, He, Ingrid, Luu, Michael, David, John, Gong, Jun, Placencio-Hickok, Veronica R., Reznik, Robert S., Tuli, Richard, Hendifar, Andrew E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639761/
https://www.ncbi.nlm.nih.gov/pubmed/31360808
http://dx.doi.org/10.1016/j.adro.2019.03.014
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author Guan, Michelle
He, Ingrid
Luu, Michael
David, John
Gong, Jun
Placencio-Hickok, Veronica R.
Reznik, Robert S.
Tuli, Richard
Hendifar, Andrew E.
author_facet Guan, Michelle
He, Ingrid
Luu, Michael
David, John
Gong, Jun
Placencio-Hickok, Veronica R.
Reznik, Robert S.
Tuli, Richard
Hendifar, Andrew E.
author_sort Guan, Michelle
collection PubMed
description PURPOSE: Bone metastases are reported in 10% to 12% of patients with neuroendocrine neoplasms (NENs) and can lead to pain and skeletal-related events (SREs), resulting in diminished quality of life and functional status. In other solid tumors with bone metastases, radiation therapy (RT) is an established treatment approach for SREs, yet few data are available in NENs historically considered to be radioresistant. We hypothesize that RT is effective for pain and other SREs in NENs and aimed to delineate any differences in pain palliation and time until progression of pain between different fractionation and dosing schedules of RT. METHODS AND MATERIALS: We retrospectively reviewed 686 records of patients with NENs treated at the institution between 2011 and 2018 and identified 28 (4.1%) patients treated with RT for 61 cases of SREs. The primary endpoint was change in patient reported pain scores after RT. RESULTS: All 28 patients experienced bone pain. Nineteen sites were treated with a single fraction (doses of 800-1800 cGy) and 42 sites with fractionated regimens (doses of 900-3750 cGy over 3-15 fractions). In 55 of 61 cases (90%), patients experienced improvement in pain after RT. The median time to recurrence or progression of pain was 3.5 months. Significant differences were found between primary site and change in performance status (P = .024), sex, and reported magnitude of pain score decrease after RT (P = .025). There were no differences in the time to the progression of pain, change in performance status, and degree of improvement in pain based on age, chemotherapy received during RT, or radiation site. Outcomes were similar for patients who received single-fraction versus fractionated regimens (P = .545) and between those receiving palliative versus ablative RT regimens (P = .812). CONCLUSIONS: Although the majority of cases in this NEN cohort benefited from RT, additional studies on the use of RT in the treatment of painful bone metastases are warranted.
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spelling pubmed-66397612019-07-29 Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms Guan, Michelle He, Ingrid Luu, Michael David, John Gong, Jun Placencio-Hickok, Veronica R. Reznik, Robert S. Tuli, Richard Hendifar, Andrew E. Adv Radiat Oncol Palliative Care PURPOSE: Bone metastases are reported in 10% to 12% of patients with neuroendocrine neoplasms (NENs) and can lead to pain and skeletal-related events (SREs), resulting in diminished quality of life and functional status. In other solid tumors with bone metastases, radiation therapy (RT) is an established treatment approach for SREs, yet few data are available in NENs historically considered to be radioresistant. We hypothesize that RT is effective for pain and other SREs in NENs and aimed to delineate any differences in pain palliation and time until progression of pain between different fractionation and dosing schedules of RT. METHODS AND MATERIALS: We retrospectively reviewed 686 records of patients with NENs treated at the institution between 2011 and 2018 and identified 28 (4.1%) patients treated with RT for 61 cases of SREs. The primary endpoint was change in patient reported pain scores after RT. RESULTS: All 28 patients experienced bone pain. Nineteen sites were treated with a single fraction (doses of 800-1800 cGy) and 42 sites with fractionated regimens (doses of 900-3750 cGy over 3-15 fractions). In 55 of 61 cases (90%), patients experienced improvement in pain after RT. The median time to recurrence or progression of pain was 3.5 months. Significant differences were found between primary site and change in performance status (P = .024), sex, and reported magnitude of pain score decrease after RT (P = .025). There were no differences in the time to the progression of pain, change in performance status, and degree of improvement in pain based on age, chemotherapy received during RT, or radiation site. Outcomes were similar for patients who received single-fraction versus fractionated regimens (P = .545) and between those receiving palliative versus ablative RT regimens (P = .812). CONCLUSIONS: Although the majority of cases in this NEN cohort benefited from RT, additional studies on the use of RT in the treatment of painful bone metastases are warranted. Elsevier 2019-04-10 /pmc/articles/PMC6639761/ /pubmed/31360808 http://dx.doi.org/10.1016/j.adro.2019.03.014 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Palliative Care
Guan, Michelle
He, Ingrid
Luu, Michael
David, John
Gong, Jun
Placencio-Hickok, Veronica R.
Reznik, Robert S.
Tuli, Richard
Hendifar, Andrew E.
Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title_full Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title_fullStr Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title_full_unstemmed Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title_short Palliative Radiation Therapy for Bone Metastases in Neuroendocrine Neoplasms
title_sort palliative radiation therapy for bone metastases in neuroendocrine neoplasms
topic Palliative Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639761/
https://www.ncbi.nlm.nih.gov/pubmed/31360808
http://dx.doi.org/10.1016/j.adro.2019.03.014
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