Single fraction radiotherapy is efficacious: A further analysis of the dutch bone metastasis study controlling for the influence of retreatment
Single fraction radiotherapy is efficacious: A further analysis of the dutch bone metastasis study controlling for the influence of retreatment
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DOI：
10.1016/j.ijrobp.2003.10.006
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发表时间：
2004-06-01
影响因子：
7
通讯作者：
Leer, JWH
中科院分区：
文献类型：
--
作者：
van der Linden, YM;Lok, JJ;Leer, JWH
目的：关于8戈伊单次分割（SF）与24戈伊多次分割（MF）对疼痛性骨转移的影响的荷兰骨转移研究显示，SF后再治疗率为24%，MF后为6%（p < 0.001）。本研究的目的是评估影响再治疗的因素及其对responsibility.Methods和Materials的影响：对所有随机患者的数据库进行了重新分析，分别计算初始治疗和retreatment.Results的反应：初始治疗的反应是71%后SF与73%后MF（p = 0.84）。再次治疗将SF的应答率提高至75%; MF保持不变（p = 0.54）。初始治疗后的缓解状态不能预测再次治疗的发生：35% SF vs. 8% MF无应答者和22% SF vs. 10% MF进行性疼痛患者再次治疗。Logistic回归分析显示随机分组和再治疗前疼痛评分显著预测再治疗（p < 0.001）。66% SF患者和33% MF患者的无应答者再治疗成功（p = 0.13）。70%SF vs. 57%MF patients（p = 0.24）.Conclusions：有或没有再治疗的影响，SF和MF放疗为疼痛性骨转移提供了同等的缓解。无论对初始治疗的反应如何，医生更愿意在单次治疗后撤退。总体而言，63%的复治患者复治有效。(C)2004年爱思唯尔公司
Purpose: The Dutch Bone Metastasis Study on the effect on painful bone metastases of 8 Gy single fraction (SF) vs. 24 Gy in multiple fractions (MF) showed 24% retreatment after SF vs. 6% after MF (p < 0.001). The purpose of the present study was to evaluate factors influencing retreatment and its effect on response.Methods and Materials: The database on all randomized patients was reanalyzed with separately calculated responses to initial treatment and retreatment.Results: Response to initial treatment was 71% after SF vs. 73% after MF (p = 0.84). Retreatment raised response to 75% for SF; MF remained unaltered (p = 0.54). The response status after initial treatment did not predict occurrence of retreatment: 35% SF vs. 8% MF nonresponders and 22% SF vs. 10% MF patients with progressive pain were retreated. Logistic regression analyses showed the randomization arm and the pain score before retreatment to significantly predict retreatment (p < 0.001). Retreatment for nonresponders was successful in 66% SF vs. 33% MF patients (p = 0.13). Retreatment for progression was successful in 70% SF vs. 57% MF patients (p = 0.24).Conclusions: With or without the effect of retreatment, SF and MF radiotherapy provided equal palliation for painful bone metastases. Irrespective of response to initial treatment, physicians were more willing to retreat after a single fraction. Overall, retreatment was effective in 63% of retreated patients. (C) 2004 Elsevier Inc.