Suzuki Gen, Yamazaki Hideya, Aibe Norihiro, Masui Koji, Kimoto Takuya, Tatekawa Kotoha, Nakashima Akinori, Takenaka Tadashi, Nishimura Takeshi, Sasaki Naomi, Oh Ryoong-Jin, Konishi Koji, Okabe Haruumi, Nagasawa Shinsuke, Yamada Kei
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Department of Radiology, Miyakojima iGRT Clinic, Osaka 534-0021, Japan.
Mol Clin Oncol. 2017 Jun;6(6):871-875. doi: 10.3892/mco.2017.1245. Epub 2017 May 8.
The present study aimed to describe the clinical results of re-irradiation (Re-RT) for spine or pelvic bone metastasis at the same initial irradiated area. Between April 2010 and March 2014, cases involving 98 patients with spine or pelvic bone metastasis who had undergone Re-RT at five institutions were reviewed. The clinical outcomes following Re-RT were evaluated, including overall survival (OS) and severe adverse events. The median time interval from initial radiation therapy (RT) to Re-RT was 439 days (range, 23-4,993 days), and the median duration of patient follow-up was 256 days (range, 11-2,284 days). The median biological effective dose for the Re-RT was 150 Gy (range, 17-240 Gy; α/β = 2). Severe late adverse events occurred in two patients who underwent three-dimensional conformal radiotherapy for lumbar spine or pelvic bone metastases, which may be associated with tumor progression. The median survival time following Re-RT was 255 days, and the actuarial OS rate at 1 year was 36%. The interval between initial RT and Re-RT, and their performance statuses (PS) were significant independent prognostic factors for OS rates in multivariate analysis. Re-RT for spine or pelvic bone metastases is a relatively acceptable option with low risk of anticipated severe adverse events, particularly for patients with good PS following a long disease-free interval.
本研究旨在描述对脊柱或骨盆骨转移灶在同一初始照射区域进行再照射（Re-RT）的临床结果。回顾了2010年4月至2014年3月期间在五家机构接受Re-RT的98例脊柱或骨盆骨转移患者的病例。评估了Re-RT后的临床结局，包括总生存期（OS）和严重不良事件。从初始放射治疗（RT）到Re-RT的中位时间间隔为439天（范围23 - 4993天），患者随访的中位持续时间为256天（范围11 - 2284天）。Re-RT的中位生物等效剂量为150 Gy（范围17 - 240 Gy；α/β = 2）。两名接受腰椎或骨盆骨转移三维适形放疗的患者发生了严重的晚期不良事件，这可能与肿瘤进展有关。Re-RT后的中位生存时间为255天，1年的精算OS率为36%。在多因素分析中，初始RT与Re-RT之间的间隔以及患者的体能状态（PS）是OS率的显著独立预后因素。对脊柱或骨盆骨转移进行Re-RT是一个相对可接受的选择，预期严重不良事件风险较低，特别是对于疾病无进展间期较长且PS良好的患者。
