(P032) Stereotactic Body Radiation Therapy for Bone Metastases From Prostate Cancer: Techniques and Outcomes From a Large Community Setting

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OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

SBRT is a very well-tolerated form of RT that appears to offer a statistically significant and high level of pain control for bone metastases from prostate cancer. In community practice, a highly variable fractionation scheme is also noted.

Ron Allison, MD, Sharon Salenius, MPH, Andrej Hnatov, MD, Cynthia Ballenger, MD, Anesa Ahamad, MD, Constantine Mantz, MD, Eduardo Fernandez, MD, Daniel Dosoretz, MD, Steven Finkelstein, MD; 21st Century Oncology

BACKGROUND: Bone metastases are a common and debilitating part of prostate cancer progression. Treatment options vary, but recently, stereotactic body radiation therapy (SBRT) has gained traction for this indication. We report response and morbidity in a cohort of men with bone metastases treated by radiosurgery in a community setting.

MATERIALS AND METHODS: We undertook an institutional review board–approved chart review of men with prostate cancer who underwent radiosurgery for bone metastases. A total of 121 men, mean age 73 years, received treatment to a total of 391 lesions. Most patients were progressing despite androgen deprivation therapy and/or chemotherapy. Bone scan, CT, and magnetic resonance imaging were commonly used for metastatic evaluation and/or treatment planning. The majority of patients (83%) were symptomatic due to bone pain at the time of SBRT. Radiosurgery was delivered by linear accelerator in 98% of patients vs 2% by CyberKnife. The mean number of lesions treated was 2.1 (range: 1–6). The spine was irradiated in 67% of patients, compared with irradiation of the ilium or sacrum in 14%, among various other bones. Fractionation was most commonly 8 Gy × 3 (34%), 5 Gy × 5 (19%), and 6 Gy × 5 (10%), followed by a variety of other schedules.

RESULTS: The mean follow-up time was 12 months (range: 0.1–80 mo). No acute morbidity was reported in 93% of patients, with grade 1/2 esophagitis seen in 4% as the most common acute side effect. There was one case of late morbidity (grade 1 lung fibrosis). The fractionation scheme did not appear to influence outcome or morbidity in this study. A statistically significant improvement in pain was seen (P = .0001), with nearly 95% reporting some level of improvement in pain.

CONCLUSIONS: SBRT is a very well-tolerated form of RT that appears to offer a statistically significant and high level of pain control for bone metastases from prostate cancer. In community practice, a highly variable fractionation scheme is also noted.

Proceedings of the 98th Annual Meeting of the American Radium Society -americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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