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Original research
Single-fraction radiation retreatment for bone metastases: role of a rapid access clinic
  1. Minsoo Kim1,
  2. Jose Alberto Maldonado1,2,
  3. Prasamsa Pandey1,
  4. Molly B El Alam1,
  5. Ramez Kouzy1,
  6. Kaitlin Christopherson1,
  7. Bruce D Minsky1,
  8. Quynh-Nhu Nugyen1,
  9. David Grosshans1,
  10. Lilie L Lin1,
  11. Melissa P Mitchell1,
  12. Ann H Klopp1,
  13. Percy P Lee1,
  14. Justin Bird3,
  15. Robert Satcher3,
  16. Valerae O Lewis3,
  17. Patrick P Lin3,
  18. Chad Tang1,
  19. Albert C Koong1,
  20. Bryan Moon3 and
  21. Lauren E Colbert1
  1. 1Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
  3. 3Orthopaedic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Lauren E Colbert, Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; LColbert{at}mdanderson.org

Abstract

Objectives This study investigates retreatment rates in single-fraction radiation therapy (SFRT) for painful bone metastasis in patients with limited life expectancy. We compared retreatment-free survival (RFS) in patients from a rapid access bone metastases clinic (RABC) and non-RABC patients, identifying factors associated with retreatment.

Methods In this observational study, we analysed RABC patients who received SFRT between April 2018 and November 2019, using non-RABC SFRT patients as a comparison group. Patients with prior or perioperative radiation therapy (RT) were excluded. The primary endpoint was same-site and any-site retreatment with RT or surgery. Patient characteristics were compared using χ2 and Student’s t-tests, with RFS estimates based on a multistate model considering death as a competing risk using Aalen-Johansen estimates.

Results We identified 151 patients (79 RABC, 72 non-RABC) with 225 treatments (102 RABC, 123 non-RABC) meeting eligibility criteria. Of the 22 (10.8%) same-site retreatments, 5 (22.7%) received surgery, 14 (63.6%) received RT and 3 (13.6%) received both RT and surgery. We found no significant differences in any-site RFS (p=0.97) or same-site RFS (p=0.11).

Conclusions RFS is high and similar comparable in the RABC and non-RABC cohorts. Retreatment rates are low, even in patients with low Eastern Cooperative Oncology Group scores.

  • Palliative Care
  • Cancer
  • Bone
  • Pain
  • Supportive care

Data availability statement

Data are available upon reasonable request. Data is available upon reasonable request and with appropriate protocols.

https://doi.org/10.1136/spcare-2023-004497

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    Data availability statement

    Data are available upon reasonable request. Data is available upon reasonable request and with appropriate protocols.

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    Footnotes

    • MK and JM contributed equally.

    • BM and LEC contributed equally.

    • Contributors MK and JAM contributed equally as first authors. BM and LEC contributed equally as senior authors. LEC is the corresponding author. LEC is the guarantor.

    • Funding This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award NRSA (TL1) Training Core (TL1TR001440) from the National Center for Advancing Translational Sciences, National Institutes of Health.

    • Competing interests PPLee reports personal fees and non-financial support from Viewray, Inc., grants, personal fees and non-financial support from AstraZeneca, Inc., personal fees and non-financial support from Varian, Inc, outside the submitted work. PPLin reports book royalties from Springer Nature, outside the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed.