title: Quality of life, fatigue and local response of patients with unstable spinal bone metastases under radiation therapy--a prospective trial.
abstract: BACKGROUND
  To evaluate the local response according to stability after radiotherapy (RT) with a special focus on quality-of-life (QoL), fatigue, pain and emotional distress in patients with unstable spinal bone metastases.
  
  
  METHODS
  In this prospective trial, 30 patients were treated from September 2011 until March 2013. The stability of osteolytic metastases in the thoracic and lumbar spine was evaluated on the basis of the Taneichi-score after three and six months. EORTC QLQ-BM22, EORTC QLQ-FA13, and QSC-R10 were assessed at baseline, and three months after RT.
  
  
  RESULTS
  After 3 months, 25% (n = 6) and after 6 months 33.3% (n = 8) were classified as stable. QoL, fatigue, and emotional distress showed no difference over the course. The pain response 3 months after RT showed a significant difference (p < 0.001). Pathological fractures occurred in 8.3% of the patients (n = 2) within six months following RT.
  
  
  CONCLUSIONS
  Our trial demonstrated that RT can improve stability in one third of patients over a 6-months period with unstable spinal metastases. Importantly, for these patients pain relief was detected but RT had no impact on QoL, fatigue, and emotional distress.
  
  
  BACKGROUND
  Clinical trial identifier NCT01409720.
authors.affiliation: Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. harald.rief@med.uni-heidelberg.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Rief
authors.forename: Maximiliane
authors.initials: M
authors.lastname: Heinhold
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Ingmar
authors.initials: I
authors.lastname: Schlampp
authors.forename: Robert
authors.initials: R
authors.lastname: Förster
authors.forename: Thomas
authors.initials: T
authors.lastname: Welzel
authors.forename: Tilman
authors.initials: T
authors.lastname: Bostel
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Stefan
authors.initials: S
authors.lastname: Rieken
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D010146:Pain / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D011878:Radiotherapy / Q000009:adverse effects*; D013125:Spinal Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary; D011795:Surveys and Questionnaires; D015996:Survival Rate