Diabetes increases the risk of serious adverse events after re-irradiation of the spine
Suppli, Morten Hiul ; Munck af Rosenschöld, Per LU
; Pappot, Helle
and Engelholm, Svend Aage
(2019)
In Radiotherapy and Oncology
136.
p.130-135
- Abstract
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%,... (More)
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 Gy 2 ; 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.
(Less)
- author
- Suppli, Morten Hiul
; Munck af Rosenschöld, Per
LU
; Pappot, Helle
and Engelholm, Svend Aage
- publishing date
- 2019-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Metastatic spinal cord compression, Palliative, Radiotherapy, Spine, Toxicity
- in
- Radiotherapy and Oncology
- volume
- 136
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85064272444
- pmid:31015114
- ISSN
- 0167-8140
- DOI
- 10.1016/j.radonc.2019.04.002
- language
- English
- LU publication?
- no
- id
- 9865e06d-f47e-4418-980e-5ea0b07f34c0
- date added to LUP
- 2020-07-28 08:37:30
- date last changed
- 2024-06-26 20:27:55
@article{9865e06d-f47e-4418-980e-5ea0b07f34c0,
abstract = {{<p> 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 Gy <sub>2</sub> ; 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. </p>}},
author = {{Suppli, Morten Hiul and Munck af Rosenschöld, Per and Pappot, Helle and Engelholm, Svend Aage}},
issn = {{0167-8140}},
keywords = {{Metastatic spinal cord compression; Palliative; Radiotherapy; Spine; Toxicity}},
language = {{eng}},
month = {{07}},
pages = {{130--135}},
publisher = {{Elsevier}},
series = {{Radiotherapy and Oncology}},
title = {{Diabetes increases the risk of serious adverse events after re-irradiation of the spine}},
url = {{http://dx.doi.org/10.1016/j.radonc.2019.04.002}},
doi = {{10.1016/j.radonc.2019.04.002}},
volume = {{136}},
year = {{2019}},
}