title: Performance status versus anatomical recovery in metastatic disease: The role of palliative radiation treatment.
abstract: Metastatic disease is a common complication of the most advanced malignancies. It may compromise the patients' quality of life, often posing a greater risk than the primary disease itself. Currently, several different therapeutic approaches are available to palliate or cure (single metastasis with primary neoplasm under control - radical surgery) secondary disease. In particular, radiation therapy is widely used, as it often leads to full or at least partial functional recovery, depending on the number and location of metastases. The aim of our study was to evaluate whether clinical improvement subsequent to radiation therapy may be related to anatomical recovery of the site of metastasis in cancer patients with metastatic disease. Given the heterogeneity of the diseases considered and the general complex conditions of the patients, a single method could not be used to evaluate the response to radiation treatment and its correlation with the performance status (PS). Thus, depending on the specific disease being assessed, we divided the patients into different groups. Patients in the same group were followed up with the same methods. This correlation was noted in a very high percentage of patients, predominantly in patients with vertebral and brain metastases. Moreover, we investigated the use of magnetic resonance imaging (MRI)-diffusion weighted imaging (DWI) in the study of spinal metastases. We propose its use in the local evaluation of vertebral secondary lesions, both in the diagnostic phase and during the assessment of treatment efficacy.
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: alfonso.reginelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.affiliation: Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy. Electronic address: radioterapia@aslnapoli1centro.it.
authors.forename: Giustino
authors.initials: G
authors.lastname: Silvestro
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: giovanni.fontanella@hotmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fontanella
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: angsangiova@gmail.com.
authors.forename: Angelo
authors.initials: A
authors.lastname: Sangiovanni
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: mario.conte@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Conte
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: iolandanuzzo@gmail.com.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Nuzzo
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: adilecce@hotmail.com.
authors.forename: Ada
authors.initials: A
authors.lastname: Di Lecce
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: antoniamartino@hotmail.it.
authors.forename: Antonia
authors.initials: A
authors.lastname: Martino
authors.affiliation: Department of Radiotherapy, University of Sassari, Sassari, Italy. Electronic address: robertagrassi@libero.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Grassi
authors.affiliation: Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy. Electronic address: radioterapia@aslnapoli1centro.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Murino
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: salvatore.cappabianca@unina2.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cappabianca
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000556:secondary; D001932:Brain Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000556:secondary; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D007558:Italy; D008297:Male; D009362:Neoplasm Metastasis; D010166:Palliative Care; D011788:Quality of Life
keywords: Brain metastases; DWI; MRI; MRI-DWI; Palliative care; Radiotherapy; Secondary disease; Spinal metastases