Bone density and fracture risk following SBRT for non-spine bone metastases.

This retrospective study evaluated local recurrence (LR) and fracture risk in non-spine bone metastases treated with SBRT. 181 lesions in 116 patients are reported. The median dose was 27 Gy (range 15-40) in 3 fractions (range 1-6). The cumulative incidence of LR was 2.8%, 7.2% and 12.5% at 6 mo, 1 yr and 2 yrs. Fractures occurred in 11 lesions (6%). Radioresistant histology and increasing PTV predicted for LR on univariate analysis, while rib location was associated with control. Increasing PTV remained a significant predictor for LR on multivariate analysis. Univariate predictors of fracture risk included female gender, lytic lesions and poorer KPS. Average CT-approximated L1 trabecular attenuation in patients with fracture was significantly lower than in patients without fracture (112.2 vs. 142.6 Hounsfield units). In the largest series to date, we report excellent local control for SBRT to non-spine bone metastases and a novel relationship between CT-based bone quality assessment and fracture risk.

Informations de copyright

© 2021 Old City Publishing, Inc.

Déclaration de conflit d'intérêts

Authors’ disclosure of potential conflicts of interest Wei Fu reports grants from NIH/NCI, during the conduct of the study. Dr. Hu reports grants from NIH/NCI, during the conduct of the study; grants from RTOG Foundation, personal fees from Merck & Co., outside the submitted work. Dr. Meyer reports sponsored research support from Boston Scientific, royalties from UpToDate, Inc., royalties and honoraria from Springer, outside the submitted work. Dr. Redmond reports grants, personal fees and travel expenses from Elekta AB; participation on the data safety monitoring board of BioMimetix; grants, personal fees and travel expenses from Accuray; and travel expenses from Brainlab, outside the submitted work. Dr. Song reports research support from Bayer, outside the submitted work. Dr. Voong reports research funding from Lung Cancer Research Foundation and honoraria from American Society of Clinical Oncology and American Society of Radiation Oncology, outside the submitted work. Drs. Cao, Stachelek, Hales, and Quon have nothing to disclose.