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Early clinical experience and outcome of helical tomotherapy for multiple metastatic lesions

Authors
 IK JAE LEE  ;  JINSIL SEONG  ;  CHANG GEOL LEE  ;  YONG BAE KIM  ;  KI CHANG KEUM  ;  CHANG OK SUH  ;  GWI EON KIM  ;  JAEHO CHO 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.73(5) : 1517-1524, 2009 
Journal Title
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 
ISSN
 0360-3016 
Issue Date
2009
MeSH
Adrenal Gland Neoplasms/radiotherapy ; Adrenal Gland Neoplasms/secondary ; Adult ; Aged ; Bone Marrow/pathology ; Bone Marrow/radiation effects* ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/secondary ; Feasibility Studies ; Female ; Humans ; Leukopenia/etiology ; Leukopenia/pathology ; Liver Neoplasms/radiotherapy ; Liver Neoplasms/secondary ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/secondary ; Male ; Middle Aged ; Neoplasm Metastasis/radiotherapy* ; Palliative Care/methods* ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated/methods* ; Treatment Outcome
Keywords
Tomotherapy ; Red bone marrow ; Multiple metastases
Abstract
PURPOSE: To evaluate the feasibility of synchronous treatment of multiple metastatic lesions by helical tomotherapy. METHODS AND MATERIALS: Forty-two patients with multiple metastatic lesions were treated by helical tomotherapy from April 2006 to February 2007. Among these patients, 21 had metastatic bone disease. Subjective pain response was assessed using the visual analogue scales, and morbidity was evaluated by Common Terminology Criteria for Adverse Events v3.0. The correlation between the percentage of red bone marrow in the radiation field and the severity of leukocytopenia was analyzed. RESULTS: The median age was 57 years. Radiation dose to the gross tumor volume was 30-84 Gy, with a median fractional size of 3 Gy. Mean treatment time was 16 min and 1 sec. Treatment time and fraction size were modified because of poor performance status or hematologic toxicity in two patients. With regard to palliative effects for bone metastasis, 16 patients (76.2%) experienced positive pain relief. Four patients had Grade III leukocytopenia, and three had Grade IV leukocytopenia. In the multivariate logistic regression, red marrow percentage was the independent risk factor most associated with Grade III/IV leukocytopenia (p = 0.014). The tolerance cutoff point of red bone marrow was 26.8%, with a sensitivity and specificity of 85.7% and 85.7%, respectively. CONCLUSIONS: Helical tomotherapy was effective for symptom palliation and was feasible for patients with multiple metastatic diseases. The volume of red bone marrow, as well as performance status, must be taken into account to determine optimal treatment
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301608031751
DOI
10.1016/j.ijrobp.2008.07.035
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Gwi Eon(김귀언)
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103747
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