Radiation-induced acute toxicities after image-guided intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for patients with spinal metastases (IRON-1 trial)

• Verfasst von: Sprave, Tetyana [VerfasserIn]
• Verfasst von: Verma, Vivek [VerfasserIn]
• Verfasst von: Förster, Robert [VerfasserIn]
• Verfasst von: Schlampp, Ingmar [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Bostel, Tilman [VerfasserIn]
• Verfasst von: Welte, Stefan Ezechiel [VerfasserIn]
• Verfasst von: Tonndorf-Martini, Eric [VerfasserIn]
• Verfasst von: El-Shafie, Rami [VerfasserIn]
• Verfasst von: Nicolay, Nils [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Rief, Harald [VerfasserIn]
• Titel: Radiation-induced acute toxicities after image-guided intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for patients with spinal metastases (IRON-1 trial)
• Titelzusatz: first results of a randomized controlled trial
• Paralleltitel: Radiogene Akuttoxizität nach bildgeführter intensitätsmodulierter Strahlentherapie versus dreidimensionaler konformaler Strahlentherapie bei Patienten mit Wirbelkörpermetastasen (IRON-1 trial)
• Verf.angabe: Tanja Sprave, Vivek Verma, Robert Förster, Ingmar Schlampp, Thomas Bruckner, Tilman Bostel, Stefan Ezechiel Welte, Eric Tonndorf-Martini, Rami El Shafie, Nils Henrik Nicolay, Jürgen Debus, Harald Rief
• E-Jahr: 2018
• Jahr: 05 July 2018
• Umfang: 10 S.
• Fussnoten: Gesehen am 02.04.2020
• Titel Quelle: Enthalten in: Strahlentherapie und Onkologie
• Ort Quelle: Berlin : Springer Medizin, 1997
• Jahr Quelle: 2018
• Band/Heft Quelle: 194(2018), 10, Seite 911-920
• ISSN Quelle: 1439-099X
• DOI: doi:10.1007/s00066-018-1333-z
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Cohort Studies
• Sach-SW: Dose Fractionation, Radiation
• Sach-SW: Female
• Sach-SW: Follow-Up Studies
• Sach-SW: Humans
• Sach-SW: Intensity-modulated radiotherapy
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Palliative Care
• Sach-SW: Palliative radiotherapy
• Sach-SW: Pilot Projects
• Sach-SW: Prospective Studies
• Sach-SW: Radiation Injuries
• Sach-SW: Radiotherapy, Conformal
• Sach-SW: Radiotherapy, Image-Guided
• Sach-SW: Radiotherapy, Intensity-Modulated
• Sach-SW: Side effects
• Sach-SW: Spinal bone metastases
• Sach-SW: Spinal Neoplasms
• Sach-SW: Toxicity
• K10plus-PPN: 1693839288

Abstract

PURPOSE: Radiation therapy (RT) provides an important treatment approach in the palliative care of vertebral metastases, but radiation-induced toxicities in patients with advanced disease and low performance status can have substantial implications for quality of life. Herein, we prospectively compared toxicity profiles of intensity-modulated radiotherapy (IMRT) vs. conventional three-dimensional conformal radiotherapy (3DCRT). - METHODS: This was a prospective randomized monocentric explorative pilot trial to compare radiation-induced toxicity between IMRT and 3DCRT for patients with spinal metastases. A total of 60 patients were randomized between November 2016 and May 2017. In both cohorts, RT was delivered in 10 fractions of 3Gy each. The primary endpoint was radiation-induced toxicity at 3 months. - RESULTS: Median follow-up was 4.3 months. Two patients suffered from grade 3 acute toxicities in the IMRT arm, along with 1 patient in the 3DCRT group. At 12 weeks after treatment (t2), 1 patient reported grade 3 toxicity in the IMRT arm vs. 4 patients in the 3DCRT group. No grade 4 or 5 adverse events occurred in either group. In the IMRT arm, the most common side effects by the end of irradiation (t1) were grade 1-2 xerostomia and nausea in 8 patients each (29.6%), and dyspnea in 7 patients (25.9%). In the 3DCRT group, the most frequent adverse events (t1) were similar: grade 1-2 xerostomia (n= 10, 35.7%), esophagitis (n= 10, 35.8%), nausea (n= 10, 35.8%), and dyspnea (n= 5, 17.9%). - CONCLUSION: This is the first randomized trial to evaluate radiation-induced toxicities after IMRT versus 3DCRT in patients with vertebral metastases. This trial demonstrated an additional improvement for IMRT in terms of acute side effects, although longer follow-up is required to further ascertain other endpoints.