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Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre

Cedric Peters, Julie Vandewiele, Yolande Lievens (UGent) , Marc Van Eijkeren (UGent) , Valerie Fonteyne (UGent) , Tom Boterberg (UGent) , Pieter Deseyne (UGent) , Liv Veldeman (UGent) , Wilfried De Neve (UGent) , Christel Monten (UGent) , et al.
Author
Organization
Abstract
Background: Single-fraction radiotherapy (SFRT) offers equal pain relief for uncomplicated painful bone metastases as compared to multiple-fraction radiotherapy (MFRT). Despite this evidence, the adoption of SFRT has been poor with published rates of SFRT for uncomplicated bone metastases ranging from <10% to 70%. We aimed to evaluate the adoption of SFRT and its evolution over time following the more formal endorsement of the international guidelines in our centre starting from 2013. Materials and methods: We performed a retrospective review of fractionation schedules at our centre for painful uncomplicated bone metastases from January 2013 until December 2017. Only patients treated with 1 x 8 Gy (SFRT-group) or 10 x 3 Gy (MFRT-group) were included. We excluded other fractionation schedules, primary cancer of the bone and post-operative radiotherapy. Uncomplicated was defined as painful but not associated with impending fracture, existing fracture or existing neurological compression. Temporal trends in SFRT/MFRT usage and overall survival were investigated. We performed a lesion-based patterns of care analysis and a patient-based survival analysis. Mann-Whitney U and Chisquare test were used to assess differences between fractionation schedules and temporal trends in prescription, with Kaplan-Meier estimates used for survival analysis (p-value <0.05 considered significant). Results: Overall, 352 patients and 594 uncomplicated bone metastases met inclusion criteria. Patient characteristics were comparable between SFRT and MFRT, except for age. Overall, SFRT was used in 92% of all metastases compared to 8% for MFRT. SFRT rates increased throughout the study period from 85% in 2013 to 95% in 2017 (p = 0.06). Re-irradiation rates were higher in patients treated with SFRT (14%) as compared to MFRT (4%) (p = 0.046). Four-week mortality and median overall survival did not differ significantly between SFRT and MFRT (17% vs 18%, p = 0.8 and 25 weeks vs 38 weeks, p = 0.97, respectively). Conclusions: Adherence to the international guidelines for SFRT for uncomplicated bone metastasis was high and increased over time to 95%, which is the highest reported rate in literature. (C)2021 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
Keywords
Bone metastases, SFRT MFRT Single fraction radiotherapy, Palliation, Patterns of practice, Uncomplicated

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MLA
Peters, Cedric, et al. “Adoption of Single Fraction Radiotherapy for Uncomplicated Bone Metastases in a Tertiary Centre.” CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY, vol. 27, 2021, pp. 64–69, doi:10.1016/j.ctro.2021.01.004.
APA
Peters, C., Vandewiele, J., Lievens, Y., Van Eijkeren, M., Fonteyne, V., Boterberg, T., … Ost, P. (2021). Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre. CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY, 27, 64–69. https://doi.org/10.1016/j.ctro.2021.01.004
Chicago author-date
Peters, Cedric, Julie Vandewiele, Yolande Lievens, Marc Van Eijkeren, Valerie Fonteyne, Tom Boterberg, Pieter Deseyne, et al. 2021. “Adoption of Single Fraction Radiotherapy for Uncomplicated Bone Metastases in a Tertiary Centre.” CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY 27: 64–69. https://doi.org/10.1016/j.ctro.2021.01.004.
Chicago author-date (all authors)
Peters, Cedric, Julie Vandewiele, Yolande Lievens, Marc Van Eijkeren, Valerie Fonteyne, Tom Boterberg, Pieter Deseyne, Liv Veldeman, Wilfried De Neve, Christel Monten, Sabine Braems, Fréderic Duprez, Katrien Vandecasteele, and Piet Ost. 2021. “Adoption of Single Fraction Radiotherapy for Uncomplicated Bone Metastases in a Tertiary Centre.” CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY 27: 64–69. doi:10.1016/j.ctro.2021.01.004.
Vancouver
1.
Peters C, Vandewiele J, Lievens Y, Van Eijkeren M, Fonteyne V, Boterberg T, et al. Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre. CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY. 2021;27:64–9.
IEEE
[1]
C. Peters et al., “Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre,” CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY, vol. 27, pp. 64–69, 2021.
@article{8698448,
  abstract     = {{Background: Single-fraction radiotherapy (SFRT) offers equal pain relief for uncomplicated painful bone metastases as compared to multiple-fraction radiotherapy (MFRT). Despite this evidence, the adoption of SFRT has been poor with published rates of SFRT for uncomplicated bone metastases ranging from <10% to 70%. We aimed to evaluate the adoption of SFRT and its evolution over time following the more formal endorsement of the international guidelines in our centre starting from 2013.

Materials and methods: We performed a retrospective review of fractionation schedules at our centre for painful uncomplicated bone metastases from January 2013 until December 2017. Only patients treated with 1 x 8 Gy (SFRT-group) or 10 x 3 Gy (MFRT-group) were included. We excluded other fractionation schedules, primary cancer of the bone and post-operative radiotherapy. Uncomplicated was defined as painful but not associated with impending fracture, existing fracture or existing neurological compression. Temporal trends in SFRT/MFRT usage and overall survival were investigated. We performed a lesion-based patterns of care analysis and a patient-based survival analysis. Mann-Whitney U and Chisquare test were used to assess differences between fractionation schedules and temporal trends in prescription, with Kaplan-Meier estimates used for survival analysis (p-value <0.05 considered significant).

Results: Overall, 352 patients and 594 uncomplicated bone metastases met inclusion criteria. Patient characteristics were comparable between SFRT and MFRT, except for age. Overall, SFRT was used in 92% of all metastases compared to 8% for MFRT. SFRT rates increased throughout the study period from 85% in 2013 to 95% in 2017 (p = 0.06). Re-irradiation rates were higher in patients treated with SFRT (14%) as compared to MFRT (4%) (p = 0.046). Four-week mortality and median overall survival did not differ significantly between SFRT and MFRT (17% vs 18%, p = 0.8 and 25 weeks vs 38 weeks, p = 0.97, respectively).

Conclusions: Adherence to the international guidelines for SFRT for uncomplicated bone metastasis was high and increased over time to 95%, which is the highest reported rate in literature. (C)2021 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.}},
  author       = {{Peters, Cedric and Vandewiele, Julie and Lievens, Yolande and Van Eijkeren, Marc and Fonteyne, Valerie and Boterberg, Tom and Deseyne, Pieter and Veldeman, Liv and De Neve, Wilfried and Monten, Christel and Braems, Sabine and Duprez, Fréderic and Vandecasteele, Katrien and Ost, Piet}},
  issn         = {{2405-6308}},
  journal      = {{CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY}},
  keywords     = {{Bone metastases,SFRT MFRT Single fraction radiotherapy,Palliation,Patterns of practice,Uncomplicated}},
  language     = {{eng}},
  pages        = {{64--69}},
  title        = {{Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre}},
  url          = {{http://dx.doi.org/10.1016/j.ctro.2021.01.004}},
  volume       = {{27}},
  year         = {{2021}},
}

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