title: A dose-response relationship for time to bone pain resolution after stereotactic body radiotherapy (SBRT) for renal cell carcinoma (RCC) bony metastases.
abstract: BACKGROUND
  To investigate the utility of stereotactic body radiotherapy (SBRT) in the treatment of painful renal cell carcinoma (RCC) bone metastases, and for a possible dose effect on time to symptom relief.
  
  
  METHODS
  Eighteen patients with 24 painful osseous lesions from metastatic RCC were treated with SBRT. The most common treatment regimens were 24 Gy in 3 fractions and 40 Gy in 5 fractions. The times from treatment to first reported pain relief and time to symptom recurrence were evaluated. Median follow-up was 38 weeks (1-156 weeks).
  
  
  RESULTS
  Seventy-eight percent of all patients had pain relief. Patients treated with a BED > 85 Gy achieved faster and more durable pain relief compared to those treated with a BED < 85 Gy. There was decrease in time to pain relief after a change in treatment regimen to 8 Gy × 5 fractions (BED = 86). There was only one patient with grade 1 skin toxicity. No neurological or other toxicity was observed.
  
  
  CONCLUSIONS
  SBRT can safely and effectively treat painful RCC bony metastases. There appears to be a relationship between radiation dose and time to stable pain relief.
authors.affiliation: Department of Radiology, Section of Radiation Oncology, Baylor College of Medicine, 6565 Fannin, Houston, TX 77030, USA
authors.forename: Pavan M
authors.initials: PM
authors.lastname: Jhaveri
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
authors.forename: Arnold C
authors.initials: AC
authors.lastname: Paulino
authors.forename: Angel I
authors.initials: AI
authors.lastname: Blanco
authors.forename: Simon S
authors.initials: SS
authors.lastname: Lo
authors.forename: E Brian
authors.initials: EB
authors.lastname: Butler
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amato
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011379:Prognosis; D016634:Radiosurgery; D015996:Survival Rate; D013997:Time Factors