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Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

Di Staso, Mario ; Gravina, Giovanni Luca ; Zugaro, Luigi ; Bonfili, Pierluigi ; Gregori, Lorenzo ; Franzese, Pietro ; Marampon, Francesco ; Vittorini, Francesca ; Moro, Roberto ; Tombolini, Vincenzo ; Di Cesare, Ernesto ; Masciocchi, Carlo Sung, Shian-Ying

PloS one, 2015-06, Vol.10 (6), p.e0129021 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients
Autor: Di Staso, Mario ; Gravina, Giovanni Luca ; Zugaro, Luigi ; Bonfili, Pierluigi ; Gregori, Lorenzo ; Franzese, Pietro ; Marampon, Francesco ; Vittorini, Francesca ; Moro, Roberto ; Tombolini, Vincenzo ; Di Cesare, Ernesto ; Masciocchi, Carlo
Sung, Shian-Ying
Assuntos: Aged ; Analgesics ; Bone Neoplasms - radiotherapy ; Bone Neoplasms - secondary ; Bone Neoplasms - therapy ; Cancer metastasis ; Cancer therapies ; Care and treatment ; Clinical trials ; Combined Modality Therapy ; Cryotherapy ; Ethics ; Female ; Health physics ; Hospitals ; Humans ; Informed consent ; Lung cancer ; Male ; Matching ; Medical schools ; Metastases ; Metastasis ; NMR ; Nuclear magnetic resonance ; Oncology ; Pain ; Pain Management ; Patients ; Prostate ; Quality of life ; Radiation ; Radiation therapy ; Radiology ; Radiotherapy ; Retrospective Studies ; Spinal cord ; Toxicity ; Tumors
É parte de: PloS one, 2015-06, Vol.10 (6), p.e0129021
Notas: Conceived and designed the experiments: MDS GLG LZ PB LG PF FM FV RM VT EDC CM. Performed the experiments: MDS GLG LZ PB LG PF FM FV RM VT EDC CM. Analyzed the data: MDS GLG LZ PB LG PF FM FV RM VT EDC CM. Contributed reagents/materials/analysis tools: CM EDC VT GLG. Wrote the paper: MDS GLG LZ PB LG PF FM FV RM VT EDC CM.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: aim of this study was to identify outcomes in pain relief and quality of life in patients with a solitary painful osseous metastasis treated by radiotherapy, cryoablation or the combination using a propensity score matching study design. 175 patients with painful bone metastases were included in the study. Twenty-five of them underwent a radiation course (20 Gy in five daily fractions) 15 days after the cryoablation. These subjects were retrospectively matched by propensity analysis with a group of subjects treated by radiotherapy (125 subjects) and with a group treated byCryoablation (25 subjects). The pain relief in terms of complete response, rate of subjects requiring analgesics after treatments and the changes in self-rated quality of life were measured. Informed consent was obtained from the subject and the study was approved by the local Ethical Committee. An higher proportion of subjects treated by cryoablation (32%) or cryoablation followed by RT (72%;) experienced a complete response compared with patients treated by radiotherapy alone (11.2%). After Bonferroni correction strategy, the addition of radiotherapy to cryoablation significantly improved the rate of complete response compared with cryoablation alone (p = 0.011) and this paralleled with an improved self-rated quality of life. Seventeen subjects (13.6%) of patients in the radiotherapy group, 9 (36%) in the cryoablation group, and 19 (76)% in the cryoablation- radiotherapy group did not require narcotic medications. The addition of radiotherapy to cryoablation favorably impacts on perceived pain, with a favorable toxicity profile. However, our data should be interpreted with caution and could serve as a framework around which to design future trials.
Editor: United States: Public Library of Science
Idioma: Inglês

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Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

Di Staso, Mario ; Gravina, Giovanni Luca ; Zugaro, Luigi ; Bonfili, Pierluigi ; Gregori, Lorenzo ; Franzese, Pietro ; Marampon, Francesco ; Vittorini, Francesca ; Moro, Roberto ; Tombolini, Vincenzo ; Di Cesare, Ernesto ; Masciocchi, Carlo Sung, Shian-Ying

United States: Public Library of Science

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