Ito Kei, Taguchi Kentaro, Nakajima Yujiro, Ogawa Hiroaki, Murofushi Keiko Nemoto
Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
Department of Radiological Sciences, Komazawa University, 1-23-1 Komazawa, Setagaya-ku, Tokyo 154-8525, Japan.
Cancers (Basel). 2022 Aug 19;14(16):4014. doi: 10.3390/cancers14164014.
(1) Background: The superiority of stereotactic body radiotherapy (SBRT) over conventional external beam radiotherapy (cEBRT) in terms of pain palliation for bone metastases remains controversial. (2) Methods: This propensity score-matched study compared the overall pain response (OR) 3 months after radiotherapy among patients with painful (≥2 points on a 0-to-10 scale) non-spine bone metastases. Patients with lesions that were treated with SBRT or cEBRT and whose pain scores were evaluated 3 months after radiotherapy were included in this study. Pain response was evaluated according to the International Consensus Criteria. (3) Results: A total of 234 lesions (SBRT, n = 129; cEBRT, n = 105) were identified in our institutional database. To reduce the confounding effects, 162 patients were selected using a propensity score-matched analysis (n = 81 for each treatment). The OR rate at 3 months after SBRT was significantly higher than that after cEBRT (76.5% vs. 56.8%; p = 0.012). A noteworthy finding of our study is that the same trend was observed even after 6 months (75.9% vs. 50.0%; p = 0.011). The 1-year local failure rates after SBRT and cEBRT were 10.2% and 33.3% (p < 0.001), respectively. (4) Conclusions: Our findings suggest that SBRT is superior to cEBRT for pain palliation in patients with non-spine bone metastases.
（1）背景：立体定向体部放疗（SBRT）在缓解骨转移疼痛方面相对于传统外照射放疗（cEBRT）的优势仍存在争议。（2）方法：这项倾向评分匹配研究比较了疼痛性（0至10分制中≥2分）非脊柱骨转移患者放疗后3个月的总体疼痛反应（OR）。本研究纳入了接受SBRT或cEBRT治疗且放疗后3个月评估疼痛评分的患者。根据国际共识标准评估疼痛反应。（3）结果：在我们的机构数据库中总共识别出234个病灶（SBRT组，n = 129；cEBRT组，n = 105）。为减少混杂效应，通过倾向评分匹配分析选择了162例患者（每种治疗方法各81例）。SBRT后3个月的OR率显著高于cEBRT后（76.5%对56.8%；p = 0.012）。我们研究的一个值得注意的发现是，即使在6个月后也观察到相同趋势（75.9%对50.0%；p = 0.011）。SBRT和cEBRT后1年的局部失败率分别为10.2%和33.3%（p < 0.001）。（4）结论：我们的研究结果表明，在缓解非脊柱骨转移患者的疼痛方面，SBRT优于cEBRT。
