Patients with a favourable prognosis are equally palliated with single and multiple fraction radiotherapy: Results on survival in the Dutch Bone Metastasis Study
Patients with a favourable prognosis are equally palliated with single and multiple fraction radiotherapy: Results on survival in the Dutch Bone Metastasis Study
复制标题
DOI：
10.1016/j.radonc.2006.02.007
复制
发表时间：
2006-03-01
影响因子：
5.7
通讯作者：
Leer, Jan Willem H.
中科院分区：
文献类型：
--
作者：
van der Linden, Yvette M.;Steentand, Elsbeth;Leer, Jan Willem H.
背景和目的：在前瞻性随机荷兰骨转移研究中，单次8戈伊与24戈伊分6次治疗疼痛性骨转移的效果，28%的患者存活超过1年。本研究的目的是分析放射治疗对长期生存患者的姑息性影响，并确定生存的预后因素。材料和方法：比较所有生存> 52周的患者的缓解率。按原发肿瘤分层的考克斯比例风险模型用于生存预后因素的多变量（MV）分析。结果：在320例生存> 52周的患者中，8戈伊后的反应为87%，24戈伊后的反应为85%（P= 0.54）。缓解持续时间和进展率相似。对于所有原发性肿瘤，预后因素的生存是一个良好的Karnofsky性能评分，没有内脏转移，和非阿片类镇痛药的摄入量（所有因素，MV P < 0.001）。结论：单次放疗应该是标准的剂量方案，所有患者的疼痛骨转移，包括患者的预期有利的生存。Karnofsky表现评分和转移性肿瘤负荷等一般指标可用于预测生存率。(c)2006爱思唯尔爱尔兰有限公司
Background and purpose: In the prospectively, randomized Dutch Bone Metastasis Study on the effect of a single fraction of 8 Gy versus 24 Gy in six fractions on painful bone metastases, 28% of the patients survived for more than 1 year. Purpose of the present study was to analyze the palliative effect of radiotherapy in long-term surviving patients, and to identify prognostic factors for survival.Material and methods: Response rates were compared in ail patients surviving > 52 weeks. The Cox proportional hazards model stratified by primary tumour was used for multivariate (MV) analyses of prognostic factors for survival.Results: In 320 patients surviving > 52 weeks, responses were 87% after 8 Gy and 85% after 24 Gy (P= 0.54). Duration of response and progression rates were similar. For all primary tumours, prognostic factors for survival were a good Karnofsky Performance Score, no visceral metastases, and non-opioid analgesics intake (all factors, MV P < 0.001).Conclusions: Single fraction radiotherapy should be the standard dose schedule for all patients with painful bone metastases, including patients with an expected favourable survival. General prognosticators as the Karnofsky Performance Score and metastatic tumour load are useful in predicting survival. (c) 2006 Elsevier Ireland Ltd.