A dose-response relationship for time to bone pain resolution after stereotactic body radiotherapy (SBRT) for renal cell carcinoma (RCC) bony metastases

Authors: Jhaveri, Pavan M.1; Teh, Bin S.2; Paulino, Arnold C.2; Blanco, Angel I.2; Lo, Simon S.3; Butler, E. Brian2; Amato, Robert J.4

Source: Acta Oncologica, Volume 51, Number 5, May 2012 , pp. 584-588(5)

Publisher: Informa Healthcare

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Background. To investigate the utility of stereotactic body radiotherapy (SBRT) in the treatment of painful renal cell carcinoma (RCC) bone metastases, and for a possible dose effect on time to symptom relief. Material and methods. Eighteen patients with 24 painful osseous lesions from metastatic RCC were treated with SBRT. The most common treatment regimens were 24 Gy in 3 fractions and 40 Gy in 5 fractions. The times from treatment to first reported pain relief and time to symptom recurrence were evaluated. Median follow-up was 38 weeks (1–156 weeks). Results. Seventy-eight percent of all patients had pain relief. Patients treated with a BED > 85 Gy achieved faster and more durable pain relief compared to those treated with a BED < 85 Gy. There was decrease in time to pain relief after a change in treatment regimen to 8 Gy × 5 fractions (BED = 86). There was only one patient with grade 1 skin toxicity. No neurological or other toxicity was observed. Conclusions. SBRT can safely and effectively treat painful RCC bony metastases. There appears to be a relationship between radiation dose and time to stable pain relief.

Document Type: Research Article

DOI: http://dx.doi.org/10.3109/0284186X.2011.652741

Affiliations: 1: 1Department of Radiology, Section of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA 2: 2Department of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas, USA 3: 3Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA 4: 4Department of Internal Medicine, Division of Oncology, University of Texas Health Sciences Center, Houston, Texas, USA

Publication date: May 1, 2012

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