Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI
Aims: To evaluate metastatic lesions within the radiation field using repeated magnetic resonance imaging (MRI) and to compare the imaging findings with pain response following radiotherapy (RT) in patients with spinal metastases (SM) from breast cancer. Material and methods: 32 Patients with SM fro...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2014-03-01
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| Series: | Journal of Bone Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137414000050 |
| _version_ | 1819055378127650816 |
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| author | Marta D. Switlyk Øyvind S. Bruland Sigmund Skjeldal John K. Hald Therese Seierstad Olga Zaikova |
| author_facet | Marta D. Switlyk Øyvind S. Bruland Sigmund Skjeldal John K. Hald Therese Seierstad Olga Zaikova |
| author_sort | Marta D. Switlyk |
| collection | DOAJ |
| description | Aims: To evaluate metastatic lesions within the radiation field using repeated magnetic resonance imaging (MRI) and to compare the imaging findings with pain response following radiotherapy (RT) in patients with spinal metastases (SM) from breast cancer.
Material and methods: 32 Patients with SM from breast cancer admitted for fractionated RT were included in this study. MRI examinations of the spine were scored for the extent of bone metastases, epidural disease and the presence and severity of vertebral fractures. Clinical response was defined according to the updated international consensus on palliative RT endpoints.
Results: At 2 and 6 months after RT, 38% and 44% of the patients were classified as responders. None of the patients developed motor deficits. Importantly, a decrease in the intraspinal tumor volume after RT was reported in all patients. Only 6% of the patients showed bone metastases progression within the RT field, whereas 60% of the patients showed disease progression outside the RT portals. 5 Patients developed new fractures after RT, and fracture progression was observed in 21 of the 38 lesions (55%). The pain response to RT did not correlate with the presence of vertebral body fracture before RT, fracture progression or other recorded MRI features of metastatic lesions.
Conclusion: RT provided excellent local tumor control in patients with SM. Most patients benefit from RT even in cases of progressive vertebral fracture. Pain response was not associated with imaging findings and MRI cannot be used to select patients at risk of not responding to RT. |
| first_indexed | 2024-12-21T13:06:34Z |
| format | Article |
| id | doaj.art-271b806a0ef1478ea0333c6c626d38b8 |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-21T13:06:34Z |
| publishDate | 2014-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-271b806a0ef1478ea0333c6c626d38b82022-12-21T19:03:00ZengElsevierJournal of Bone Oncology2212-13742014-03-01315910.1016/j.jbo.2014.02.003Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRIMarta D. Switlyk0Øyvind S. Bruland1Sigmund Skjeldal2John K. Hald3Therese Seierstad4Olga Zaikova5Department of Radiology and Nuclear Medicine, Norwegian Radium Hospital, Oslo University Hospital, P.O. Box 4950, Nydalen 0424, NorwayInstitute of Clinical Medicine, University of Oslo, NorwayDepartment of Orthopedics, Norwegian Radium Hospital, Oslo University Hospital, NorwayDepartment of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, NorwayDepartment of Radiology and Nuclear Medicine, Norwegian Radium Hospital, Oslo University Hospital, P.O. Box 4950, Nydalen 0424, NorwayDepartment of Orthopedics, Norwegian Radium Hospital, Oslo University Hospital, NorwayAims: To evaluate metastatic lesions within the radiation field using repeated magnetic resonance imaging (MRI) and to compare the imaging findings with pain response following radiotherapy (RT) in patients with spinal metastases (SM) from breast cancer. Material and methods: 32 Patients with SM from breast cancer admitted for fractionated RT were included in this study. MRI examinations of the spine were scored for the extent of bone metastases, epidural disease and the presence and severity of vertebral fractures. Clinical response was defined according to the updated international consensus on palliative RT endpoints. Results: At 2 and 6 months after RT, 38% and 44% of the patients were classified as responders. None of the patients developed motor deficits. Importantly, a decrease in the intraspinal tumor volume after RT was reported in all patients. Only 6% of the patients showed bone metastases progression within the RT field, whereas 60% of the patients showed disease progression outside the RT portals. 5 Patients developed new fractures after RT, and fracture progression was observed in 21 of the 38 lesions (55%). The pain response to RT did not correlate with the presence of vertebral body fracture before RT, fracture progression or other recorded MRI features of metastatic lesions. Conclusion: RT provided excellent local tumor control in patients with SM. Most patients benefit from RT even in cases of progressive vertebral fracture. Pain response was not associated with imaging findings and MRI cannot be used to select patients at risk of not responding to RT.http://www.sciencedirect.com/science/article/pii/S2212137414000050Bone metastasesBreast cancerMRIPain responseRadiotherapy |
| spellingShingle | Marta D. Switlyk Øyvind S. Bruland Sigmund Skjeldal John K. Hald Therese Seierstad Olga Zaikova Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI Journal of Bone Oncology Bone metastases Breast cancer MRI Pain response Radiotherapy |
| title | Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI |
| title_full | Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI |
| title_fullStr | Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI |
| title_full_unstemmed | Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI |
| title_short | Radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated MRI |
| title_sort | radiotherapy for spinal metastases from breast cancer with emphasis on local disease control and pain response using repeated mri |
| topic | Bone metastases Breast cancer MRI Pain response Radiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2212137414000050 |
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