Incidence and treatment patterns of complicated bone metastases in a population-based radiotherapy program

Abstract Introduction There is abundant evidence in support of single fraction (SF) radiation therapy (RT) for uncomplicated bone metastases (BoM). We sought to determine the proportion of BoM that is complicated in a population-based RT program in order to act as a potential guide for assessing SFR...

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Bibliographic Details
Published in:Radiotherapy and oncology 2016-03, Vol.118 (3), p.552-556
Main Authors: Tiwana, Manpreet S, Barnes, Mark, Yurkowski, Emily, Roden, Kelsey, Olson, Robert A
Format: Article
Language:English
Subjects:
Aged
Bone Neoplasms - radiotherapy
Bone Neoplasms - secondary
Complicated bone metastases
Dose Fractionation
Female
Hematology, Oncology and Palliative Medicine
Humans
Incidence
Lung Neoplasms - pathology
Male
Middle Aged
Palliative Care - methods
Palliative radiotherapy
Population-based
Radiation therapy fractionation
Radiotherapy - methods
Radiotherapy - statistics & numerical data
Randomized Controlled Trials as Topic - statistics & numerical data
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Summary:Abstract Introduction There is abundant evidence in support of single fraction (SF) radiation therapy (RT) for uncomplicated bone metastases (BoM). We sought to determine the proportion of BoM that is complicated in a population-based RT program in order to act as a potential guide for assessing SFRT utilization rates. Materials and methods A total of 3200 RT courses were prescribed to 1880 consecutive patients diagnosed with BoM in 2013. Associations between choice of RT fractionation and BoM characterization, whether complicated or not, were assessed with logistic regression. Results The incidence of complicated BoM was 34.4%, resulting most often from adverse features of actual pathological fracture (42.1%), and neurological compromise (36.3%). Complicated BoM were most common in lung cancers (24.2%) and in the spine (68.5%), followed by extremity (15.2%) and pelvis (14.4%). SFRT was prescribed less commonly in complicated versus un-complicated BoM (39.4% vs. 70.4%; p < 0.001), which was confirmed on multivariable analysis (OR 0.32; 95% CI 0.28–0.61; p < 0.001). Conclusions This study found that 34.4% of BoM are complicated by fracture, or neurological compromise (i.e. 65.6% were un-complicated), and that they were less likely to receive SFRT. A reasonable benchmark for SFRT utilization should be at least 60%.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2015.10.015