Palliative Care

PV QA 3 - Poster Viewing Q&A 3

TU_32_3053 - Radiation therapy combined with bone-modifying agents improves local control and prognosis of osteolytic bone metastases in breast cancer

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Radiation therapy combined with bone-modifying agents improves local control and prognosis of osteolytic bone metastases in breast cancer
H. Tanaka1, M. Ito1, T. Yamaguchi1, K. Hachiya1, C. Makita2, F. Hyodo3, and M. Matsuo1; 1Gifu University, Department of Radiology, Gifu, Japan, 2Gifu Prefectural General Medical Center, Gifu, Japan, 3Gifu University, Department of Frontier Science for Imaging, Gifu, Japan

Purpose/Objective(s): Bone-modifying agents (BMAs) are frequently used for treating patients diagnosed with bone metastases. They are reportedly associated with a decrease in skeletal-related events (SREs). Although used to treat SRE, radiation therapy (RT) is primarily indicated for the prevention of spinal cord compression or pathological fractures. We evaluated the usefulness of RT for bone metastasis treatment in comparison with BMAs only.

Materials/Methods: Osteolytic bone metastases of the spine or pelvic bone in patients with breast cancer were evaluated in this study. Tomographic imaging was used to evaluate 28 lesions before and after RT + BMA, 8 lesions before and after RT alone, and 15 lesions before and after BMA treatment. Median age of the patients was 62 (range, 33-82) years. None of the lesions were treated with chemotherapy or molecular target drugs during the follow-up period for evaluating local response. For calculation of overall survival (OS) rate, the periods using chemotherapy or molecular target drugs after RT and/or BMA were included. The median follow-up period was 18 (range, 2-90) months. Response to therapy was evaluated based on the revised Response Evaluation Criteria in Solid Tumors guideline version 1.1. Patients with complete or partial response were considered as responders, and those with stable or progressive disease were considered as non-responders.

Results: There was no significant difference in the rate of improvement in osteolytic metastases between the RT-only group (50.0%) and BMA-only group (33.3%) (p = 0.657). Most lytic lesions treated with RT + BMA showed bone reformation (75.0%). Decreased fluorodeoxyglucose uptake and improvement of signal abnormalities on magnetic resonance imaging were also confirmed. Although some lytic lesions improved after using BMA only (33.3%), most remained unchanged or gradually worsened. The rate of improvement with RT + BMA was significantly higher than that with BMA only (p = 0.001). The cumulative incidence rate of response at 6 months was 54.4% in the RT + BMA group and 27.5% in the BMA-only group. OS rate in the responder group (83.1% at 1 year) was significantly higher than that in the non-responder group (37.5% at 1 year) (p = 0.029).
CR or PR SD or PD p value
BMA-only 5 10 0.0109
RT ± BMA 21 7

Conclusion: RT combined with BMA is more useful than BMA only for osteolytic bone metastasis treatment. Patients with improved osteolytic bone metastases might expect good prognosis.

Author Disclosure: H. Tanaka: None. M. Ito: None. T. Yamaguchi: None. K. Hachiya: None. F. Hyodo: None.

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