title: Evaluation of treatment results and toxicity in cases of repeated radiation therapy of spinal metastasis.
abstract: The study evaluates retrospective results and toxicity in repeated radiation therapy in patients with recurrent pain caused by backbone metastasis, having undergone previous radiotherapy in the same body region. Fifty-seven patients were analyzed: 24 women and 33 men, aged 45-74 years (median = 59 years). They underwent a second radiation therapy treatment of the spinal column, between March 2002 and May 2004, performed due to recurrent pain in the previously irradiated region. The radiation used cobalt isotope 60 ((60)Co), to include the metastatically changed vertebrae and the margin of the adjusting healthy upper and lower vertebra. The radiated skin area measured 84-104 cm(2). Patients were divided into 3 groups depending on their treatment schemas: 12 patients -- first course of radiotherapy 4 Gy x 5, second 4 Gy x 5; 16 patients -- first course of radiotherapy 4 Gy x 5, second 8 Gy x 1; 29 patients -- first course of radiotherapy 8 Gy x 1, second 8 Gy x 1. The time delay between the first and the second radiation therapies was between 11 and 766 days (median = 135 days). An analgesic effect was achieved with most treated patients -- 41/57 (71.9%) with the use of second radiotherapy and with an insignificant percentage of complications, unimportant from the clinical point of view. No serious complications such as paralysis, paresis, spinal cord necrosis, neurological dysfunction of urethral or sigmoidorectal sphincters were noted in any of the treated patients. Based on our experience, this retrospective analysis shows usefulness of the second radiotherapy treatment as a safe method of palliative treatment in cases of painful bone metastasis appearing after a previous radiation therapy.
authors.affiliation: Department of Radiotherapy, The Center of Oncology, 85-796 Bydgoszcz, Poland. roszkowskik@co.bydgoszcz.pl
authors.forename: K
authors.initials: K
authors.lastname: Roszkowski
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary; D002574:Cervical Vertebrae / Q000528:radiation effects; D003037:Cobalt Radioisotopes / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011832:Radiation Injuries / Q000175:diagnosis*; D019233:Retreatment; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D013899:Thoracic Neoplasms / Q000532:radiotherapy / Q000556:secondary
chemical_list: D003037:Cobalt Radioisotopes