Bone density and fracture risk following SBRT for non-spine bone metastases.

IF 0.7 Q4 SURGERY Journal of radiosurgery and SBRT Pub Date : 2021-01-01

Yilin Cao, Gregory C Stachelek, Wei Fu, Daniel Y Song, Russell K Hales, K Ranh Voong, Jeffrey J Meyer, Harry Quon, Chen Hu, Kristin J Redmond

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Abstract

Purpose/methods: This retrospective study evaluated local recurrence (LR) and fracture risk in non-spine bone metastases treated with SBRT.

Results: 181 lesions in 116 patients are reported. The median dose was 27 Gy (range 15-40) in 3 fractions (range 1-6). The cumulative incidence of LR was 2.8%, 7.2% and 12.5% at 6 mo, 1 yr and 2 yrs. Fractures occurred in 11 lesions (6%). Radioresistant histology and increasing PTV predicted for LR on univariate analysis, while rib location was associated with control. Increasing PTV remained a significant predictor for LR on multivariate analysis. Univariate predictors of fracture risk included female gender, lytic lesions and poorer KPS. Average CT-approximated L1 trabecular attenuation in patients with fracture was significantly lower than in patients without fracture (112.2 vs. 142.6 Hounsfield units).

Conclusion: In the largest series to date, we report excellent local control for SBRT to non-spine bone metastases and a novel relationship between CT-based bone quality assessment and fracture risk.

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SBRT治疗非脊柱骨转移的骨密度和骨折风险。

目的/方法:本回顾性研究评估SBRT治疗非脊柱骨转移瘤的局部复发(LR)和骨折风险。结果:报告116例患者181个病变。中位剂量为27 Gy(范围15-40)，分为3组(范围1-6)。6个月、1年和2年的LR累积发生率分别为2.8%、7.2%和12.5%。11例(6%)发生骨折。单变量分析显示，放射耐药组织学和PTV升高预测LR，而肋骨位置与对照相关。在多变量分析中，PTV的增加仍然是LR的重要预测因子。骨折风险的单因素预测因素包括女性性别、溶解性病变和较差的KPS。骨折患者的L1小梁平均ct近似衰减明显低于无骨折患者(112.2比142.6 Hounsfield单位)。结论:在迄今为止最大的系列研究中，我们报告了SBRT对非脊柱骨转移的良好局部控制，以及基于ct的骨质量评估与骨折风险之间的新关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of radiosurgery and SBRT SURGERY-

CiteScore

1.40

自引率

8.30%

发文量