Early response assessment of re-ossification after palliative conventional radiotherapy for vertebral bone metastases

Eiji Nakada, Shinsuke Sugihara, Masaaki Kataoka, Natsumi Yamashita, Takayuki Furumatsu, Tomoyuki Takigawa, Tomoko Tetsunaga, Toshihumi Ozaki

Research output: Contribution to journalArticle

Abstract

Background: To evaluate the therapeutic outcomes in patients with bone metastases receiving radiotherapy (RT), it is important to use objective radiological response criteria. The aim of this study was to investigate the changes in pain and re-ossification after RT for painful vertebral bone metastases without paralysis by malignant spinal cord compression. Methods: The participants included 55 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. Bone modifying agents (BMAs) were administered in all patients. Follow-up assessments were done just before the start of RT and at 1, 2, 3, 4, and 6 months after RT. Radiological responses of irradiated vertebrae by RT were assessed by computed tomography (CT) using MD Anderson response classification criteria (MDA criteria) and the pain response was assessed by Numeric Rating Scale (NRS). Response was classified as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD). Results: The rates of CR were 2%, 7%, 20%, 30%, and 56% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were 15%, 49%, 77%, 91%, and 91% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were significantly higher in patients with breast cancer than in patients with lung cancer (p = 0.043). At one month, there was an association between the NRS and radiological response assessed by MDA criteria. There was a significant trend that, with a better response, there were more patients without pain (p = 0.021). Conclusions: Under BMAs administration, successful RT for vertebral bone metastases decreased pain and caused re-ossification. The MD Anderson criteria could be useful for assessment of radiological responses of irradiated vertebrae.

Original languageEnglish
JournalJournal of Orthopaedic Science
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Osteogenesis
Radiotherapy
Neoplasm Metastasis
Bone and Bones
Pain
Paralysis
Spine
Spinal Cord Compression
Lung Neoplasms
Tomography
Breast Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{02d34428b1e9471abf4347571df68e3d,
title = "Early response assessment of re-ossification after palliative conventional radiotherapy for vertebral bone metastases",
abstract = "Background: To evaluate the therapeutic outcomes in patients with bone metastases receiving radiotherapy (RT), it is important to use objective radiological response criteria. The aim of this study was to investigate the changes in pain and re-ossification after RT for painful vertebral bone metastases without paralysis by malignant spinal cord compression. Methods: The participants included 55 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. Bone modifying agents (BMAs) were administered in all patients. Follow-up assessments were done just before the start of RT and at 1, 2, 3, 4, and 6 months after RT. Radiological responses of irradiated vertebrae by RT were assessed by computed tomography (CT) using MD Anderson response classification criteria (MDA criteria) and the pain response was assessed by Numeric Rating Scale (NRS). Response was classified as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD). Results: The rates of CR were 2{\%}, 7{\%}, 20{\%}, 30{\%}, and 56{\%} at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were 15{\%}, 49{\%}, 77{\%}, 91{\%}, and 91{\%} at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were significantly higher in patients with breast cancer than in patients with lung cancer (p = 0.043). At one month, there was an association between the NRS and radiological response assessed by MDA criteria. There was a significant trend that, with a better response, there were more patients without pain (p = 0.021). Conclusions: Under BMAs administration, successful RT for vertebral bone metastases decreased pain and caused re-ossification. The MD Anderson criteria could be useful for assessment of radiological responses of irradiated vertebrae.",
author = "Eiji Nakada and Shinsuke Sugihara and Masaaki Kataoka and Natsumi Yamashita and Takayuki Furumatsu and Tomoyuki Takigawa and Tomoko Tetsunaga and Toshihumi Ozaki",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jos.2018.08.018",
language = "English",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Early response assessment of re-ossification after palliative conventional radiotherapy for vertebral bone metastases

AU - Nakada, Eiji

AU - Sugihara, Shinsuke

AU - Kataoka, Masaaki

AU - Yamashita, Natsumi

AU - Furumatsu, Takayuki

AU - Takigawa, Tomoyuki

AU - Tetsunaga, Tomoko

AU - Ozaki, Toshihumi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: To evaluate the therapeutic outcomes in patients with bone metastases receiving radiotherapy (RT), it is important to use objective radiological response criteria. The aim of this study was to investigate the changes in pain and re-ossification after RT for painful vertebral bone metastases without paralysis by malignant spinal cord compression. Methods: The participants included 55 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. Bone modifying agents (BMAs) were administered in all patients. Follow-up assessments were done just before the start of RT and at 1, 2, 3, 4, and 6 months after RT. Radiological responses of irradiated vertebrae by RT were assessed by computed tomography (CT) using MD Anderson response classification criteria (MDA criteria) and the pain response was assessed by Numeric Rating Scale (NRS). Response was classified as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD). Results: The rates of CR were 2%, 7%, 20%, 30%, and 56% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were 15%, 49%, 77%, 91%, and 91% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were significantly higher in patients with breast cancer than in patients with lung cancer (p = 0.043). At one month, there was an association between the NRS and radiological response assessed by MDA criteria. There was a significant trend that, with a better response, there were more patients without pain (p = 0.021). Conclusions: Under BMAs administration, successful RT for vertebral bone metastases decreased pain and caused re-ossification. The MD Anderson criteria could be useful for assessment of radiological responses of irradiated vertebrae.

AB - Background: To evaluate the therapeutic outcomes in patients with bone metastases receiving radiotherapy (RT), it is important to use objective radiological response criteria. The aim of this study was to investigate the changes in pain and re-ossification after RT for painful vertebral bone metastases without paralysis by malignant spinal cord compression. Methods: The participants included 55 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. Bone modifying agents (BMAs) were administered in all patients. Follow-up assessments were done just before the start of RT and at 1, 2, 3, 4, and 6 months after RT. Radiological responses of irradiated vertebrae by RT were assessed by computed tomography (CT) using MD Anderson response classification criteria (MDA criteria) and the pain response was assessed by Numeric Rating Scale (NRS). Response was classified as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD). Results: The rates of CR were 2%, 7%, 20%, 30%, and 56% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were 15%, 49%, 77%, 91%, and 91% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were significantly higher in patients with breast cancer than in patients with lung cancer (p = 0.043). At one month, there was an association between the NRS and radiological response assessed by MDA criteria. There was a significant trend that, with a better response, there were more patients without pain (p = 0.021). Conclusions: Under BMAs administration, successful RT for vertebral bone metastases decreased pain and caused re-ossification. The MD Anderson criteria could be useful for assessment of radiological responses of irradiated vertebrae.

UR - http://www.scopus.com/inward/record.url?scp=85056476550&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056476550&partnerID=8YFLogxK

U2 - 10.1016/j.jos.2018.08.018

DO - 10.1016/j.jos.2018.08.018

M3 - Article

C2 - 30448075

AN - SCOPUS:85056476550

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

ER -