Stereotactic body radiation eases spinal cancer pain

2019 09 16 03 57 7061 Astro 2019 400

Stereotactic body radiation therapy (SBRT) is superior to conventional radiation therapy for relieving pain caused by spinal cancer metastases, according to a new study presented on October 26 at the American Society for Radiation Oncology (ASTRO) annual meeting.

The phase II/III randomized controlled study compared effects from giving a total of 24 Gy in two fractions with SBRT against a total of 20 Gy in five fractions with conventional radiation therapy (CRT). The study, which was conducted by the Canadian Cancer Trials Group, found superior pain control for the SBRT arm compared with CRT; after three months, the complete response rate was 35% for SBRT compared with 14% for CRT, a statistically significant result.

Furthermore, pain control in responders lasted for the six months duration of the study, they reported at the meeting, which was held in a virtual format from October 24-28.

However, the researchers found no differences in control of cancer or survival rates. Both regimens were tolerable and patient surveys indicated an improvement in quality of life measures related to financial concerns.

During an October 26 press briefing, moderator Dr. Sue Yom, PhD, described the data as "practice-changing."

Delivering radiation to precise areas of the body in a short number of treatments has obvious advantages over conventional radiation therapy, such as reduced exposure to radiation for patients and health personnel. However, in many cases it is more expensive and does require evidence to justify use, said Yom, a radiation oncologist at the University of California, San Francisco.

A reduction in the number of treatments from five to two made a quantifiable difference for patients, she noted.

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