Henry C Y Wong, Shing Fung Lee, Samuel Ryu, Adrian Wai Chan, Saverio Caini, Peter Johnstone, Yvette van der Linden, Joanne M van der Velden, Emily Martin, Sara Alcorn, Candice Johnstone, J Isabelle Choi, Gustavo Nader Marta, Eva Oldenburger, Srinivas Raman, Agata Rembielak, Vassilios Vassiliou, Pierluigi Bonomo, Quynh-Nhu Nguyen, Shirley Tse, Peter J Hoskin, Charles B Simone
{"title":"近期临床试验对脊柱转移性肿瘤立体定向放射治疗meta分析的影响,迫切需要一致的研究终点。","authors":"Henry C Y Wong, Shing Fung Lee, Samuel Ryu, Adrian Wai Chan, Saverio Caini, Peter Johnstone, Yvette van der Linden, Joanne M van der Velden, Emily Martin, Sara Alcorn, Candice Johnstone, J Isabelle Choi, Gustavo Nader Marta, Eva Oldenburger, Srinivas Raman, Agata Rembielak, Vassilios Vassiliou, Pierluigi Bonomo, Quynh-Nhu Nguyen, Shirley Tse, Peter J Hoskin, Charles B Simone","doi":"10.21037/apm-24-145","DOIUrl":null,"url":null,"abstract":"<p><p>Pain from spinal metastases can result in significant impact to patients' quality of life. Conventional external beam radiation therapy (cEBRT) has long been shown to be effective in the pain control of patients with spinal metastases. With the advancement in radiation therapy, stereotactic body radiation therapy (SBRT) has been increasingly adopted for the treatment of spinal metastases. Multiple randomised controlled trials (RCT) have been performed to evaluate whether SBRT provides better pain relief compared to cEBRT. Previous meta-analyses showed that SBRT have significantly better complete pain response at 3 months compared to cEBRT. This report updates meta-analyses by incorporating the complete pain response data obtained from personal communication with the NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631 principal investigator and the recently published RCT by Guckenberger et al. The results demonstrate that the results for complete pain response at 3 months have now changed and no longer favour SBRT. It is postulated that inconsistent definitions and reporting of study endpoints, specifically regarding vertebral compression fractures induced by radiation therapy, could be possible reasons for the difference in meta-analyses results. A consensus for standardizing study endpoints for future clinical trials in SBRT for painful bone metastases is needed to allow for better interpretation of study results.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 2","pages":"155-159"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of recent clinical trials on meta-analysis of stereotactic body radiation therapy for spine metastases and urgent call for consistent study endpoints.\",\"authors\":\"Henry C Y Wong, Shing Fung Lee, Samuel Ryu, Adrian Wai Chan, Saverio Caini, Peter Johnstone, Yvette van der Linden, Joanne M van der Velden, Emily Martin, Sara Alcorn, Candice Johnstone, J Isabelle Choi, Gustavo Nader Marta, Eva Oldenburger, Srinivas Raman, Agata Rembielak, Vassilios Vassiliou, Pierluigi Bonomo, Quynh-Nhu Nguyen, Shirley Tse, Peter J Hoskin, Charles B Simone\",\"doi\":\"10.21037/apm-24-145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Pain from spinal metastases can result in significant impact to patients' quality of life. Conventional external beam radiation therapy (cEBRT) has long been shown to be effective in the pain control of patients with spinal metastases. With the advancement in radiation therapy, stereotactic body radiation therapy (SBRT) has been increasingly adopted for the treatment of spinal metastases. Multiple randomised controlled trials (RCT) have been performed to evaluate whether SBRT provides better pain relief compared to cEBRT. Previous meta-analyses showed that SBRT have significantly better complete pain response at 3 months compared to cEBRT. This report updates meta-analyses by incorporating the complete pain response data obtained from personal communication with the NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631 principal investigator and the recently published RCT by Guckenberger et al. The results demonstrate that the results for complete pain response at 3 months have now changed and no longer favour SBRT. It is postulated that inconsistent definitions and reporting of study endpoints, specifically regarding vertebral compression fractures induced by radiation therapy, could be possible reasons for the difference in meta-analyses results. A consensus for standardizing study endpoints for future clinical trials in SBRT for painful bone metastases is needed to allow for better interpretation of study results.</p>\",\"PeriodicalId\":7956,\"journal\":{\"name\":\"Annals of palliative medicine\",\"volume\":\"14 2\",\"pages\":\"155-159\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of palliative medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/apm-24-145\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Nursing\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of palliative medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/apm-24-145","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}
Impact of recent clinical trials on meta-analysis of stereotactic body radiation therapy for spine metastases and urgent call for consistent study endpoints.
Pain from spinal metastases can result in significant impact to patients' quality of life. Conventional external beam radiation therapy (cEBRT) has long been shown to be effective in the pain control of patients with spinal metastases. With the advancement in radiation therapy, stereotactic body radiation therapy (SBRT) has been increasingly adopted for the treatment of spinal metastases. Multiple randomised controlled trials (RCT) have been performed to evaluate whether SBRT provides better pain relief compared to cEBRT. Previous meta-analyses showed that SBRT have significantly better complete pain response at 3 months compared to cEBRT. This report updates meta-analyses by incorporating the complete pain response data obtained from personal communication with the NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631 principal investigator and the recently published RCT by Guckenberger et al. The results demonstrate that the results for complete pain response at 3 months have now changed and no longer favour SBRT. It is postulated that inconsistent definitions and reporting of study endpoints, specifically regarding vertebral compression fractures induced by radiation therapy, could be possible reasons for the difference in meta-analyses results. A consensus for standardizing study endpoints for future clinical trials in SBRT for painful bone metastases is needed to allow for better interpretation of study results.
期刊介绍:
Annals of Palliative Medicine (Ann Palliat Med; Print ISSN 2224-5820; Online ISSN 2224-5839) is an open access, international, peer-reviewed journal published quarterly with both online and printed copies since 2012. The aim of the journal is to provide up-to-date and cutting-edge information and professional support for health care providers in palliative medicine disciplines to improve the quality of life for patients and their families and caregivers.