Radiological Response and Clinical Outcome in Patients with Femoral Bone Metastases after Radiotherapy
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概要
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We evaluated the radiological response and clinical outcome in patients with femoral bone metastases after radiotherapy. 102 consecutive patients with femoral metastases without pathological fracture were treated by surgery or radiotherapy between 2002 and 2005. Twelve of them initially treated with surgery were excluded from this study. The remaining 90 patients with 102 lesions underwent radiation therapy as the initial treatment. Twelve patients who died within 30 days by disease progression and 6 who were lost to follow-up were excluded. The remaining 72 patients with 84 lesions including 43 impending fractures were enrolled in this analysis. Radiological changes were categorized into complete response, partial response, no change, and progressive disease based on plain radiograph findings. Pain relief was reviewed for 77 painful lesions. The median radiation dose was 30 Gy. No re-irradiation was performed. 35 lesions (42%) achieved radiological responses median 3 months after radiotherapy. Pain relief was obtained in 36 of 77 lesions (47%). There was no significant correlation between radiological response and pain relief (P = 0.166). Eleven lesions eventually required surgery and considered as treatment failure. The treatment failure rate in the radiological progressive disease (PD) group (8/19, 42%) was significantly higher than that in the non-PD group (3/65, 5%) (P < 0.001). Among 43 impending fracture lesions, 15 lesions (36%) experienced radiological response and 35 lesions (81%) required no surgical interventions. Our data suggest that radiotherapy can enable metastatic bone healing and avoid surgery in many lesions. However, radiological PD lesions often require surgery after radiotherapy.
著者
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原田 英幸
静岡県立静岡がんセンター放射線治療科
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鎌田 実
静岡県立静岡がんセンター放射線治療科
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SAKAHARA Harumi
Department of Radiology, Hamamatsu University School of Medicine
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HASHIMOTO TAKAYUKI
Division of Radiation Oncology, Shizuoka Cancer Center
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NISHIMURA TETSUO
Division of Radiation Oncology, Shizuoka Cancer Center
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YOSHIOKA Yasuo
Division of Multidisciplinary Radiotherapy, Osaka University Graduate School of Medicine
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HARADA Hideyuki
Division of Radiation Oncology, Shizuoka Cancer Center
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KAMATA Minoru
Division of Radiation Oncology, Shizuoka Cancer Center
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ASAKURA Hirofumi
Division of Radiation Oncology, Shizuoka Cancer Center
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FURUTANI Kazuhisa
Division of Radiation Oncology, Shizuoka Cancer Center
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Sakahara Harumi
Department Of Nuclear Medicine And Diagnostic Imaging Kyoto University School Of Medicine
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Harada Hideyuki
Division Of Radiation Oncology Shizuoka Cancer Center
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Furutani Kazuhisa
Division Of Radiation Oncology Shizuoka Cancer Center
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Katagiri Hirohisa
Division Of Orthopedic Oncology Shizuoka Cancer Center
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Nishimura Tetsuo
Division Of Radiation Oncology Shizuoka Cancer Center
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Asakura Hirofumi
Division Of Radiation Oncology Shizuoka Cancer Center
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KATAGIRI Hirohisa
Orthopedic Oncology, Shizuoka Cancer Center
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TAKAHASHI Mitsuru
Orthopedic Oncology, Shizuoka Cancer Center
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Hashimoto Takayuki
Division Of Radiation Oncology Shizuoka Cancer Center Hospital
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Hashimoto Takayuki
Division Of Radiation Oncology Shizuoka Cancer Center
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Kamata Minoru
Division Of Radiation Oncology Shizuoka Cancer Center
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NISHIMURA Tetsuo
Divisions of Radiation Oncology, Shizuoka Cancer Center
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FURUTANI Kazuhisa
Divisions of Radiation Oncology, Shizuoka Cancer Center
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HARADA Hideyuki
Divisions of Radiation Oncology, Shizuoka Cancer Center
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YOSHIOKA Yasuo
Divisions of Radiation Oncology, Shizuoka Cancer Center
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ASAKURA Hirofumi
Divisions of Radiation Oncology, Shizuoka Cancer Center
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KAMATA Minoru
Divisions of Radiation Oncology, Shizuoka Cancer Center
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