title: Variability in the point to which single direct field irradiation is prescribed for spinal bone metastases: a survey of practice patterns in Japan.
abstract: Direct single fields are commonly used in radiotherapy for spinal bone metastases, and it is crucial to define the point for which the dose is prescribed. According to the guidelines from the International Bone Metastases Consensus Working Party (IBMCWP) updated in 2010, different opinions exist on whether this therapy should be prescribed to the mid-vertebral or anterior vertebral body. To our knowledge, no previous studies have surveyed practice patterns regarding this discrepancy. Therefore, we performed an Internet-based survey of members of the Japanese Radiation Oncology Study Group (JROSG) to investigate the current practice patterns in Japan. The respondents mentioned the point to which they prescribed radiotherapy for a single direct field. A total of 52 radiation oncologists from 50 institutions (36% of JROSG institutions) responded. Respondent prescription for radiotherapy varied widely. Only 21% and 6% of respondents prescribed irradiation to the mid-vertebral body and anterior vertebral body, respectively. A larger proportion of respondents (27%) prescribed irradiation to the spinal cord (center of the spinal canal). Still another group of respondents (27%) stated that they never use a single direct field. In conclusion, the point to which irradiation dosages are prescribed varies widely for a single direct field in cases of spinal bone metastases. This variation may lead some radiation oncologists to misunderstand the tolerance dosage of the spinal cord, especially in cases of re-irradiation. Thus, careful consideration is required before any prescriptions are made.
authors: Department of Radiation Oncology, St Luke's International Hospital, 9-1, Akashicho, Chuouku, Tokyo, 104-8560, Japan.
authors: Naoki
authors: N
authors: Nakamura
authors: Naoto
authors: N
authors: Shikama
authors: Hitoshi
authors: H
authors: Wada
authors: Hideyuki
authors: H
authors: Harada
authors: Miwako
authors: M
authors: Nozaki
authors: Hisayasu
authors: H
authors: Nagakura
authors: Masao
authors: M
authors: Tago
authors: Masahiko
authors: M
authors: Oguchi
authors: Nobue
authors: N
authors: Uchida
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D020266:Radiotherapy, Conformal / Q000379:methods* / Q000706:statistics & numerical data*; D013125:Spinal Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000556:secondary*
keywords: bone metastases; patterns of care study; prescription point; radiotherapy; spine
references: Radiother Oncol. 2002 Sep;64(3):275-80
references: 12242115
references: Radiother Oncol. 1999 Aug;52(2):111-21
references: 10577696
references: Clin Oncol (R Coll Radiol). 2001;13(2):88-90
references: 11373885
references: Radiother Oncol. 1998 Jun;47(3):233-40
references: 9681885
references: Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):1730-7
references: 21489705
references: Radiother Oncol. 1997 Nov;45(2):109-16
references: 9423999
references: Radiother Oncol. 2006 Jun;79(3):278-84
references: 16793154
references: Radiother Oncol. 2005 Apr;75(1):54-63
references: 15878101
references: Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):e117-20
references: 22381902
references: Clin Oncol (R Coll Radiol). 2012 Mar;24(2):112-24
references: 22130630
references: J Natl Cancer Inst. 2005 Jun 1;97(11):798-804
references: 15928300
references: Radiother Oncol. 1999 Aug;52(2):101-9
references: 10577695
references: Int J Radiat Oncol Biol Phys. 2011 Mar 15;79(4):965-76
references: 21277118
references: Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):851-5
references: 15708265
references: Clin Oncol (R Coll Radiol). 2006 Mar;18(2):125-8
references: 16523812
references: Radiother Oncol. 1986 Aug;6(4):247-55
references: 3775071