Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases

Dawn Owen, Nadia N Laack, Charles S. Mayo, Yolanda Isabel Garces, Sean S Park, Heather J. Bauer, Kathryn Nelson, Robert W. Miller, Paul D. Brown, Kenneth R. Olivier

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Purpose: Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases. Methods and Materials: Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity < 90 days) and late toxicity (defined as toxicity ≥. 90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria. Results: The median age of patients treated was 60 years. The most common histology was prostate cancer (31%) and most patients had fewer than 3 sites of disease at the time of simulation (64%). Most of the non-spine bony sites lay within the pelvis (65%). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8% at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 1-2 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities. Conclusions: Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects.

Original languageEnglish (US)
JournalPractical Radiation Oncology
Volume4
Issue number2
DOIs
StatePublished - Mar 2014

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Radiotherapy
Bone and Bones
Neoplasm Metastasis
Disease-Free Survival
Histology
Dose Fractionation
Spontaneous Fractures
Survival
Acute Pain
Pelvis
Fatigue
Prescriptions
Prostatic Neoplasms
Spine
Recurrence
Lung
Liver
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases. / Owen, Dawn; Laack, Nadia N; Mayo, Charles S.; Garces, Yolanda Isabel; Park, Sean S; Bauer, Heather J.; Nelson, Kathryn; Miller, Robert W.; Brown, Paul D.; Olivier, Kenneth R.

In: Practical Radiation Oncology, Vol. 4, No. 2, 03.2014.

Research output: Contribution to journalArticle

Owen, Dawn ; Laack, Nadia N ; Mayo, Charles S. ; Garces, Yolanda Isabel ; Park, Sean S ; Bauer, Heather J. ; Nelson, Kathryn ; Miller, Robert W. ; Brown, Paul D. ; Olivier, Kenneth R. / Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases. In: Practical Radiation Oncology. 2014 ; Vol. 4, No. 2.
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abstract = "Purpose: Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases. Methods and Materials: Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity < 90 days) and late toxicity (defined as toxicity ≥. 90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria. Results: The median age of patients treated was 60 years. The most common histology was prostate cancer (31{\%}) and most patients had fewer than 3 sites of disease at the time of simulation (64{\%}). Most of the non-spine bony sites lay within the pelvis (65{\%}). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8{\%} at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 1-2 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities. Conclusions: Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects.",
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AU - Owen, Dawn

AU - Laack, Nadia N

AU - Mayo, Charles S.

AU - Garces, Yolanda Isabel

AU - Park, Sean S

AU - Bauer, Heather J.

AU - Nelson, Kathryn

AU - Miller, Robert W.

AU - Brown, Paul D.

AU - Olivier, Kenneth R.

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