Source:Radiotherapy and Oncology
Author(s): Darby Erler, Drew Brotherston, Arjun Sahgal, Patrick Cheung, Andrew Loblaw, William Chu, Hany Soliman, Hans Chung, Alex Kiss, Edward Chow, Ian Poon
AimsTo report local control and toxicity rates for patients treated with stereotactic body radiotherapy (SBRT) for non-spine bone metastases.Methods and materialsEighty-one patients with 106 non-spine bone metastases were treated between 2011 and 2014 and retrospectively reviewed. Indications included: oligometastases (63%), oligoprogression (17.3%), retreatment (2.4%) or other (17.3%). Cumulative incidence function was used to assess local recurrence and fracture probability. Bivariate relationships were investigated based on selected patient, tumour and dose–volume factors.ResultsMean follow-up was 13 months (range, 0.25–45.6) and the median patient age was 66.4 years (range, 36–86). Most patients were male (60.5%) and the predominant histology prostate cancer (32%). Bone metastases were most commonly located in the pelvis (41.5%) and almost half sclerotic. The most common prescriptions were 30 Gy/5 (30.2%) and 35 Gy/5 (42.5%). The cumulative incidence of local recurrence at 6,18 and 24 months respectively was 4.7%, 8.3% and 13.3% with a mean time to local recurrence of 11.8 months (range, 3.9–23.4). A significant association was found between local recurrence and volume of the PTV (p = 0.02), with larger PTVs having a greater risk of local failure. Fracture was observed radiographically in the treatment volume in 9/106 (8.5%) of treated lesions and the mean time to fracture was 8.4 months (range, 0.7–32.5 months). With respect to predictors, a trend was observed for lytic lesions (p = 0.11) and female gender (p = 0.09).ConclusionsThe results of this study confirm that SBRT yields high rates of long-term local control for non-spine bone metastases with a low fracture risk.
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