Hurt so good.

The results of RTOG 0631 were a bit of a surprise when they showed no improvement in (in fact, numerically worse) pain response for spine SBRT compared to conventional 8 Gy x 1. In the meantime, the use of consolidative SBRT for oligometastatic cancer has been on the rise. While a primary goal of such treatment is obviously to eradicate disease, another question is whether pain control is “better” with SBRT. Better is a highly subjective term meaning response, duration, and / or a variety of patient reported outcomes. In this single-center series of 131 patients with bone mets in the setting of oligometastatic cancer, there was no significant difference in overall pain response or quality of life between conventional 3D treatment and SBRT. However, metastasis control and re-irradiation rates were better after SBRT. TBL: Pain control alone isn’t an indication for using SBRT techniques for a bone met. | van de Ven, Int J Radiat Oncol Biol Phys 2020


  1. Insufficient dose in SBRT arm? Protocol allowed 16 Gy in 80% coverage, which probably equated to ~10-12 Gy to D95.


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