PMID- 28751228
OWN - NLM
STAT- MEDLINE
DCOM- 20180709
LR  - 20181202
IS  - 1879-8519 (Electronic)
IS  - 1879-8500 (Linking)
VI  - 7
IP  - 6
DP  - 2017 Nov-Dec
TI  - Consideration of patient and disease characteristics in selecting radiation 
      regimens for treatment of bone metastases.
PG  - 403-410
LID - S1879-8500(17)30189-3 [pii]
LID - 10.1016/j.prro.2017.06.008 [doi]
AB  - PURPOSE: Radiation therapy is one of the mainstays of treatment for painful bone 
      metastases; however, the optimal fractionation and dosing of radiation for a 
      given patient and disease characteristics are still subject to debate. METHODS 
      AND MATERIALS: We retrospectively examined 475 patients who received radiation 
      for bone metastases at our institution from 2009 through 2014 and evaluated 
      survival outcomes based on parameters of their first treatment course and patient 
      demographics. Kaplan-Meier analysis was used to analyze factors associated with 
      overall survival (OS). A recursive partition analysis (RPA) was used to generate 
      a decision tree of patient characteristics resulting in significant differences 
      in survival. A Cox model was used to verify the RPA and evaluate the significance 
      of biologically equivalent dose (BED) along with other factors. RESULTS: In our 
      cohort, median age was 62 years and median Karnofsky performance status (KPS) was 
      70. Survival time by primary tumor type: breast (median, 35.9 months), prostate 
      (12.8 months), other (median, 11.0 months), lung (median, 5.3 months), and 
      gastrointestinal (median, 4.0 months) (P < .0001). Primary tumor type and KPS 
      significantly affected survival, whereas age was also significant for survival in 
      certain primary tumor types. Pain control was not found to be significantly 
      affected by primary tumor type (P = .72) or BED (P = .14). CONCLUSION: Our data 
      demonstrate that selection of radiation fractionation schedules should take into 
      account primary tumor type, KPS, and age, and we have generated an RPA model 
      including these factors to help guide decision making. We also found that shorter 
      fractionation schedules are as effective as longer fractionation schedules for 
      pain control, regardless of primary tumor type.
CI  - Copyright (c) 2017 American Society for Radiation Oncology. Published by Elsevier 
      Inc. All rights reserved.
FAU - Liu, Yufei
AU  - Liu Y
AD  - Stanford School of Medicine, Stanford, California.
FAU - von Eyben, Rie
AU  - von Eyben R
AD  - Department of Radiation Oncology, Stanford Comprehensive Cancer Center, Stanford, 
      California.
FAU - Kidd, Elizabeth A
AU  - Kidd EA
AD  - Department of Radiation Oncology, Stanford Comprehensive Cancer Center, Stanford, 
      California. Electronic address: ekidd@stanford.edu.
LA  - eng
PT  - Journal Article
DEP - 20170623
PL  - United States
TA  - Pract Radiat Oncol
JT  - Practical radiation oncology
JID - 101558279
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Neoplasms/*mortality/*radiotherapy/secondary
MH  - Child
MH  - Child, Preschool
MH  - *Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Karnofsky Performance Status
MH  - Male
MH  - Middle Aged
MH  - Pain Management
MH  - Palliative Care
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Survival Rate
EDAT- 2017/07/29 06:00
MHDA- 2018/07/10 06:00
CRDT- 2017/07/29 06:00
PHST- 2017/05/19 00:00 [received]
PHST- 2017/06/15 00:00 [revised]
PHST- 2017/06/19 00:00 [accepted]
PHST- 2017/07/29 06:00 [pubmed]
PHST- 2018/07/10 06:00 [medline]
PHST- 2017/07/29 06:00 [entrez]
AID - S1879-8500(17)30189-3 [pii]
AID - 10.1016/j.prro.2017.06.008 [doi]
PST - ppublish
SO  - Pract Radiat Oncol. 2017 Nov-Dec;7(6):403-410. doi: 10.1016/j.prro.2017.06.008. 
      Epub 2017 Jun 23.