Diabetes increases the risk of serious adverse events after re-irradiation of the spine
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Diabetes increases the risk of serious adverse events after re-irradiation of the spine. / Suppli, Morten Hiul; Munck Af Rosenschöld, Per; Pappot, Helle; Engelholm, Svend Aage.
I: Radiotherapy & Oncology, Bind 136, 2019, s. 130-135.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Diabetes increases the risk of serious adverse events after re-irradiation of the spine
AU - Suppli, Morten Hiul
AU - Munck Af Rosenschöld, Per
AU - Pappot, Helle
AU - Engelholm, Svend Aage
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2019
Y1 - 2019
N2 - INTRODUCTION: In this study we investigate the risk of radiation-induced serious adverse event of the spine in a large cohort of consecutive retreated patients with palliative radiotherapy (RT) for metastatic cancer in the spine.METHODS AND MATERIALS: From 2010 to 2014, 2387 patients received spinal irradiation with a palliative intent for metastatic spinal cord compression at our institution. The patients were reviewed for prior RT and 220 patients had received re-irradiation of the spine. Clinical and treatment data were obtained from the patients' records and the RT planning system.RESULTS: Patients had metastatic disease from breast, prostate, lung, hematological or other cancers (22.7%, 21.8%, 21.4%, 3.2% and 30.9%, respectively). Median follow-up was 99 days. Median cumulative EQD2 was 57.6 Gy2; range: 20.0-90.0 Gy. Spinal events related to re-irradiation were observed in fourteen patients; six patients were diagnosed with radiation-induced myelopathy (RIM) and nine patients with radiation-induced vertebral fracture (RIF). In a multivariate analysis, diabetes was related to increased risk of toxicity (HR = 7.9; P = 0.003).CONCLUSION: The incidence of RIM and RIF (6 and 9 out of 220 patients, respectively) was low in our cohort of re-irradiated patients. Patients with diabetes had a higher risk of adverse events which should be considered before re-irradiation of the spine.
AB - INTRODUCTION: In this study we investigate the risk of radiation-induced serious adverse event of the spine in a large cohort of consecutive retreated patients with palliative radiotherapy (RT) for metastatic cancer in the spine.METHODS AND MATERIALS: From 2010 to 2014, 2387 patients received spinal irradiation with a palliative intent for metastatic spinal cord compression at our institution. The patients were reviewed for prior RT and 220 patients had received re-irradiation of the spine. Clinical and treatment data were obtained from the patients' records and the RT planning system.RESULTS: Patients had metastatic disease from breast, prostate, lung, hematological or other cancers (22.7%, 21.8%, 21.4%, 3.2% and 30.9%, respectively). Median follow-up was 99 days. Median cumulative EQD2 was 57.6 Gy2; range: 20.0-90.0 Gy. Spinal events related to re-irradiation were observed in fourteen patients; six patients were diagnosed with radiation-induced myelopathy (RIM) and nine patients with radiation-induced vertebral fracture (RIF). In a multivariate analysis, diabetes was related to increased risk of toxicity (HR = 7.9; P = 0.003).CONCLUSION: The incidence of RIM and RIF (6 and 9 out of 220 patients, respectively) was low in our cohort of re-irradiated patients. Patients with diabetes had a higher risk of adverse events which should be considered before re-irradiation of the spine.
U2 - 10.1016/j.radonc.2019.04.002
DO - 10.1016/j.radonc.2019.04.002
M3 - Journal article
C2 - 31015114
VL - 136
SP - 130
EP - 135
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
SN - 0167-8140
ER -
ID: 224600338