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。

4区 医学 Q2 Nursing
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
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引用次数: 0

摘要

脊柱转移引起的疼痛会对患者的生活质量产生重大影响。传统的外束放射治疗(cEBRT)长期以来被证明对脊柱转移患者的疼痛控制有效。随着放射治疗技术的进步,立体定向体放射治疗(SBRT)越来越多地用于脊柱转移瘤的治疗。已经进行了多项随机对照试验(RCT)来评估SBRT是否比cEBRT提供更好的疼痛缓解。先前的荟萃分析显示,与cEBRT相比,SBRT在3个月时的完全疼痛反应明显更好。本报告通过纳入与NRG肿瘤放射治疗肿瘤组(RTOG) 0631首席研究员的个人交流和Guckenberger等人最近发表的随机对照试验获得的完整疼痛反应数据,更新了荟萃分析。结果表明,3个月时完全疼痛反应的结果现在已经改变,不再支持SBRT。假设研究终点的定义和报告不一致,特别是关于放射治疗引起的椎体压缩性骨折,可能是meta分析结果差异的原因。为了更好地解释研究结果,需要就SBRT治疗疼痛性骨转移的未来临床试验的研究终点标准化达成共识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Annals of palliative medicine
Annals of palliative medicine Medicine-Anesthesiology and Pain Medicine
自引率
0.00%
发文量
231
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.
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