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Open Access 01-03-2018 | Original Research

Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique

Authors: Paulien G. Westhoff, Alexander de Graeff, Evelyn M. Monninkhof, Ilse de Pree, Marco van Vulpen, Jan Willem H. Leer, Corrie A. M. Marijnen, Yvette M. van der Linden, The Dutch Bone Metastasis Study Group

Published in: Journal of Radiation Oncology | Issue 1/2018

Abstract

Background

Conventional radiotherapy for painful spinal metastases can be delivered with a single posterior-anterior (PA) or two opposed anterior-posterior (APPA) fields. We studied the effectiveness and toxicity of both techniques and studied whether treatment technique was predictive for abdominal and skin toxicity.

Patients and methods

Within the Dutch Bone Metastasis Study, 343 patients received 8 Gray in a single fraction or 24 Gray in six fractions for painful spinal metastases. Treatment technique was not randomized. At baseline and weekly during follow-up, patients reported pain and other physical complaints. Any complaint increasing within 4 weeks after treatment was noted as a side effect. Pain response was calculated according to international standards, taking into account changes in pain score and medication. Repeated measurement analyses and multivariate logistic analyses were performed.

Results

Patients were mainly treated on the thoracic (34%) and lumbar (53%) spine and 73% received a PA field. Pain response was similar between both techniques (74%). In patients treated at the thoraco-lumbar and lumbar spine, with multiple fractions, significantly more abdominal complaints were noticed. In multivariate analysis, radiotherapy technique did not predict for side effects.

Conclusion

Conventional radiotherapy of painful spinal metastases provides limited toxicity. Radiotherapy technique is not an independent predictor of abdominal and skin toxicity of irradiation.

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Title: Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique
Authors: Paulien G. Westhoff
Alexander de Graeff
Evelyn M. Monninkhof
Ilse de Pree
Marco van Vulpen
Jan Willem H. Leer
Corrie A. M. Marijnen
Yvette M. van der Linden
The Dutch Bone Metastasis Study Group
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Radiation Oncology / Issue 1/2018
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-017-0328-1

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