Dosimetric and clinical impact of 3D vs. 2D planning in palliative radiotherapy for bone metastases.

Purpose: The incorporation of three-dimensional (3D) planning for the treatment of bone metastases has been embraced in many North American practices with assumed superior tumor targeting, sparing of normal structures, and improvement in patient outcomes. The goal of our project was to evaluate the...

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Publicado en:Supportive Care in Cancer Vol. 21; no. 8; pp. 2229 - 2236
Autores principales: Pope, Kathy, Fitzpatrick, David, Potter, Andrew, Holwell, Michael, Wang, Lisa, Lau, Michelle, Levin, Wilfred, McLean, Michael, Balaura, Laura Zurawel, Bezjak, Andrea, Wong, Rebecca K S
Formato: research Journal Article
Publicado: Springer Nature Aug2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Dosimetric and clinical impact of 3D vs. 2D planning in palliative radiotherapy for bone metastases.
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        au:
          Pope, Kathy
          Fitzpatrick, David
          Potter, Andrew
          Holwell, Michael
          Wang, Lisa
          Lau, Michelle
          Levin, Wilfred
          McLean, Michael
          Balaura, Laura Zurawel
          Bezjak, Andrea
          Wong, Rebecca K S
        affil: Palliative Radiation Oncology Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.
      sug:
        subj:
          Bone Neoplasms Radiotherapy
          Palliative Care Methods
          Radiotherapy, Computer-Assisted Methods
          Radiotherapy, Conformal Methods
          Adult
          Aged
          Aged, 80 and Over
          Anorexia Etiology
          Bone Neoplasms
          Fatigue Etiology
          Female
          Human
          Male
          Middle Age
          Nausea Etiology
          Pain Etiology
          Prospective Studies
          Radiation Dosage
          Radiotherapy, Computer-Assisted Adverse Effects
          Radiotherapy, Conformal Adverse Effects
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Purpose: The incorporation of three-dimensional (3D) planning for the treatment of bone metastases has been embraced in many North American practices with assumed superior tumor targeting, sparing of normal structures, and improvement in patient outcomes. The goal of our project was to evaluate the dosimetric and clinical impact of 3D vs. two-dimensional (2D) planning for patients who require simple palliative radiotherapy techniques (≤ 2 beams) for bone metastases.Methods: Patients undergoing palliative radiation therapy for bone metastases were eligible. The study oncologists first documented the intended treatment target, defined the treatment target/field using digital radiographs (2D), followed by using full 3D planning computerized tomography volumetric datasets. Treatment plans were compared dosimetrically, and patient-reported outcomes (pain, fatigue, anorexia, and nausea) were compared against a historical cohort treated with 2D plans.Results: Eighty-five patients were enrolled in the study group. Review of the 3D datasets led to changes in the target area of interest in 44/85 (52 %) of cases, of which 21/85 (25 %) were clinically significant. 3D plans resulted in superior target coverage and normal tissue sparing. There was no significant difference in patient-reported outcomes however.Conclusion: 3D radiotherapy planning resulted in superior treatment plans but we were unable to demonstrate a significant benefit in clinical outcomes. Prospective study designs are needed to describe the contemporary expectation of palliative radiotherapy for bone metastases in the modern era of 3D planning.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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