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Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials

BACKGROUND: Pain relief is one of the main objectives of radiotherapy for cancer patients with bone metastases. Stereotactic body radiotherapy (SBRT) enables precise delivery of a higher dosage to the target area. Several trials have reported comparisons between SBRT and conventional radiotherapy (c...

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Autores principales: Wang, Zilan, Li, Longyuan, Yang, Xingyu, Teng, Haiying, Wu, Xiaoxiao, Chen, Zhouqing, Wang, Zhong, Chen, Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627033/
https://www.ncbi.nlm.nih.gov/pubmed/36338685
http://dx.doi.org/10.3389/fonc.2022.979201
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author Wang, Zilan
Li, Longyuan
Yang, Xingyu
Teng, Haiying
Wu, Xiaoxiao
Chen, Zhouqing
Wang, Zhong
Chen, Gang
author_facet Wang, Zilan
Li, Longyuan
Yang, Xingyu
Teng, Haiying
Wu, Xiaoxiao
Chen, Zhouqing
Wang, Zhong
Chen, Gang
author_sort Wang, Zilan
collection PubMed
description BACKGROUND: Pain relief is one of the main objectives of radiotherapy for cancer patients with bone metastases. Stereotactic body radiotherapy (SBRT) enables precise delivery of a higher dosage to the target area. Several trials have reported comparisons between SBRT and conventional radiotherapy (cRT) in patients with painful bone metastasis. However, the results of those investigations were inconsistent, and no systematic review or meta-analysis has been done till now. METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Clinicaltrials.gov up to May 1, 2022 for relevant studies. Patients with painful bone metastasis who received SBRT or cRT were included. The primary outcome was the patients’ pain response rate at three months. The secondary outcomes included the rate of pain responders at one month and six months, oral morphine equivalent dose (OMED) use, and any adverse events. STATA software 12.0 was used for the statistical analysis. RESULTS: We collected 533 patients’ data from 4 randomized controlled trials (RCTs), there was a significant difference of pain response rate at 3 months between two groups (RR = 1.41, 95% CI: 1.12-1.77, I(2) = 0.0%, P = 0.003). However, no significant difference was found in pain response rate at 1 month (RR = 1.19, 95% CI: 0.91-1.54, I(2) = 31.5%, P = 0.201) and 6 months (RR = 1.25, 95% CI: 0.93-1.69, I(2) = 0.0%, P = 0.140). OMED consumption was not significantly different in patients treated with SBRT compared with control group (WMD = -1.11, 95% CI: -17.51-15.28, I(2) = 0.0%, P = 0.894). For safety outcome, no statistical difference was found between SBRT and cRT (RR = 0.72, 95% CI: 0.46-1.14, I(2)=20.1%, P = 0.162). CONCLUSION: This study shows that for painful bone metastases, patients with SBRT experienced better pain relief 3 months after radiation than patients with cRT, and SBRT did not increase the incidence of adverse events. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2022-6-0099/, identifier INPLASY202260099.
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spelling pubmed-96270332022-11-03 Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials Wang, Zilan Li, Longyuan Yang, Xingyu Teng, Haiying Wu, Xiaoxiao Chen, Zhouqing Wang, Zhong Chen, Gang Front Oncol Oncology BACKGROUND: Pain relief is one of the main objectives of radiotherapy for cancer patients with bone metastases. Stereotactic body radiotherapy (SBRT) enables precise delivery of a higher dosage to the target area. Several trials have reported comparisons between SBRT and conventional radiotherapy (cRT) in patients with painful bone metastasis. However, the results of those investigations were inconsistent, and no systematic review or meta-analysis has been done till now. METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Clinicaltrials.gov up to May 1, 2022 for relevant studies. Patients with painful bone metastasis who received SBRT or cRT were included. The primary outcome was the patients’ pain response rate at three months. The secondary outcomes included the rate of pain responders at one month and six months, oral morphine equivalent dose (OMED) use, and any adverse events. STATA software 12.0 was used for the statistical analysis. RESULTS: We collected 533 patients’ data from 4 randomized controlled trials (RCTs), there was a significant difference of pain response rate at 3 months between two groups (RR = 1.41, 95% CI: 1.12-1.77, I(2) = 0.0%, P = 0.003). However, no significant difference was found in pain response rate at 1 month (RR = 1.19, 95% CI: 0.91-1.54, I(2) = 31.5%, P = 0.201) and 6 months (RR = 1.25, 95% CI: 0.93-1.69, I(2) = 0.0%, P = 0.140). OMED consumption was not significantly different in patients treated with SBRT compared with control group (WMD = -1.11, 95% CI: -17.51-15.28, I(2) = 0.0%, P = 0.894). For safety outcome, no statistical difference was found between SBRT and cRT (RR = 0.72, 95% CI: 0.46-1.14, I(2)=20.1%, P = 0.162). CONCLUSION: This study shows that for painful bone metastases, patients with SBRT experienced better pain relief 3 months after radiation than patients with cRT, and SBRT did not increase the incidence of adverse events. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2022-6-0099/, identifier INPLASY202260099. Frontiers Media S.A. 2022-10-19 /pmc/articles/PMC9627033/ /pubmed/36338685 http://dx.doi.org/10.3389/fonc.2022.979201 Text en Copyright © 2022 Wang, Li, Yang, Teng, Wu, Chen, Wang and Chen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Wang, Zilan
Li, Longyuan
Yang, Xingyu
Teng, Haiying
Wu, Xiaoxiao
Chen, Zhouqing
Wang, Zhong
Chen, Gang
Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title_full Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title_fullStr Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title_full_unstemmed Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title_short Efficacy and safety of stereotactic body radiotherapy for painful bone metastases: Evidence from randomized controlled trials
title_sort efficacy and safety of stereotactic body radiotherapy for painful bone metastases: evidence from randomized controlled trials
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627033/
https://www.ncbi.nlm.nih.gov/pubmed/36338685
http://dx.doi.org/10.3389/fonc.2022.979201
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