Comparing 8GY Vs 30 GY Schedules of Palliative Radiotherapy in the Treatment of Painful Spine Metastasis

Narmadha, R (2017) Comparing 8GY Vs 30 GY Schedules of Palliative Radiotherapy in the Treatment of Painful Spine Metastasis. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Bone metastasis may be seen in 85% of patients dying due to cancer of breast, prostate and lung. Bone metastasis is more common in breast and prostate cancer accounting for 70% of metastasis. Around 30-40% of bone metastasis is due to cancer of thyroid, kidney and lung. carcinomas of gastrointestinal tract gives rise to bone metastasis in 3-15% of patients. less commonly lymphoma can cause bone destruction. AIM OF THE STUDY: To compare the pain relief at the end of 3 months in patients treated with 8Gy in single fraction and conventional schedule of 30Gy in 10 fractions for painful spine metastasis. METHODS AND MATERIAL: Study was done in 60 patients with painful spine metastasis with biopsy proven primay tumour elsewhere without impending fracture of spine or spinal cord compression. patients with life expectancy more than 3 months were assessed for pain using visual analog scale(VAS) prior to radiation and treated with either 8Gy given in one day or 30Gy given in 10 fractions for two weeks. Pain response and toxicity was assessed at week1, week 4 and week 12 in both the groups and those with persistent pain or recurrent pain were reirradiated. RESULTS: Overall response was 83.3% in arm 1 and 86.6% in arm 2. There was no statistically significant difference between both the arms in terms of pain response rate, duration of response or acute toxicity.Response rate did not correlate with primary site histology,age,sex or spine level. Two patients were reiirradiated in the single 8Gy arm compared to none in the multifractionated schedule. CONCLUSION: Single fraction radiotherapy of 8Gy given in one day is equally effective and more convenient for patients and care givers.In high volume centres, short course schedule needs to be considered for palliation as it is cost-effective and more convenient for the treatment unit as well.

Item Type: Thesis (Masters)
Additional Information: Reg.No.201419002
Uncontrolled Keywords: spine metastasis, pain scale, external beam radiation and single fraction.
Subjects: MEDICAL > Radio Therapy
Depositing User: Subramani R
Date Deposited: 20 Jul 2020 16:42
Last Modified: 20 Jul 2020 16:42

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