Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
Pract Radiat Oncol. 2019 Mar;9(2):81-88. doi: 10.1016/j.prro.2018.11.006. Epub 2018 Nov 30.
This study aimed to determine the pain response rates after conventional radiation therapy (RT) for painful bone metastases in prospective nonrandomized studies, which better reflect daily practice than randomized controlled trials.
A literature search was conducted in PubMed and Scopus for articles published between 2002 and 2018. We only included articles in which pain response after RT was assessed using the International Consensus Endpoint initially published in 2002, or the updated version from 2012. In addition, to be included in this review, the study design was required to be prospective or based on prospectively collected data. Our primary outcomes of interest were the overall and complete response rates after conventional RT for bone metastases.
Of the 2863 articles identified in our database search, 12 met the inclusion criteria. Six studies excluded patients with features of complicated bone metastases. Only 2 papers reported exclusion criteria regarding analgesic use. Radiation schedules that were frequently used were 1 × 8 Gy, 5 × 4 Gy, and 10 × 3 Gy. The overall response rate in evaluable patients was 55%, and 754 of the 1379 evaluable patients experienced a complete or partial response. The complete response rate was 15% (196 of 1348 evaluable patients). In the intent-to-treat patient group, the overall response rate was 29% (754 of 2559 enrolled patients), and the complete response rate 8% (196 of 2528 enrolled patients).
We determined the pain response rates after conventional RT for painful bone metastases in prospective nonrandomized studies. The present review may provide benchmarks for future nonrandomized studies that investigate palliative RT for bone metastases.
本研究旨在确定前瞻性非随机研究中常规放疗（RT）治疗骨转移疼痛的疼痛缓解率，这些研究比随机对照试验更能反映日常实践。
在 PubMed 和 Scopus 中进行了文献检索，检索了 2002 年至 2018 年期间发表的文章。我们仅纳入了使用国际共识终点（2002 年首次发表或 2012 年更新版）评估 RT 后疼痛缓解的文章。此外，为了纳入本综述，研究设计需要是前瞻性的或基于前瞻性收集的数据。我们感兴趣的主要结局是常规 RT 治疗骨转移的总体和完全缓解率。
在我们的数据库搜索中，共确定了 2863 篇文章，其中 12 篇符合纳入标准。6 项研究排除了有复杂骨转移特征的患者。仅有 2 篇论文报告了关于镇痛药使用的排除标准。常用的放射方案是 1×8Gy、5×4Gy 和 10×3Gy。可评估患者的总体缓解率为 55%，1379 例可评估患者中有 754 例出现完全或部分缓解。完全缓解率为 15%（1348 例可评估患者中有 196 例）。在意向治疗患者组中，总体缓解率为 29%（2559 例入组患者中有 754 例），完全缓解率为 8%（2528 例入组患者中有 196 例）。
我们确定了前瞻性非随机研究中常规 RT 治疗骨转移疼痛的疼痛缓解率。本综述可为未来研究骨转移姑息性 RT 的非随机研究提供基准。
