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Pain response after stereotactic body radiation therapy versus conventional radiotherapy in patients with bone metastases - a phase II, randomized controlled trial within a prospective cohort

B. Pielkenrood, J. M. Van der Velden, Y. M. van der Linden, M. Bartels, N. Kasperts, J. Verhoeff, W. Eppinga, R. Gal et al.

International Journal of Radiation Oncology, Biology, Physics, 2020

45 participants · 64 citations

Abstract

BACKGROUND

Pain response after conventional external beam radiotherapy (cRT) in patients with painful bone metastases is observed in 60-70% of patients. The aim of the XXXXX trial was to investigate whether stereotactic body radiotherapy (SBRT) improves pain response.

METHODS

This single center, phase 2, randomized controlled trial was conducted within the XXXXX cohort, which consists of patients referred for radiotherapy of bone metastases to our tertiary center. Cohort participants with painful bone metastases who gave broad informed consent for randomization, were randomly assigned to cRT or SBRT. Only patients in the intervention arm received information about the trial, and were offered SBRT (1x18 Gy, 3x10 Gy or 5x7 Gy) which they could accept or refuse. Refusing patients underwent standard cRT (1x8 Gy, 5x4 Gy or 10x3 Gy). Patients in the control arm were not informed. Primary endpoint was pain response at 3 months after radiotherapy. Secondary outcomes were pain response at any point within 3 months, mean pain scores, and toxicity. Data was analyzed intention to treat (ITT) and per protocol (PP). This trial was registered with Clinicaltrials.gov, XXXX FINDINGS: Between Jan 29, 2015, and March 20, 2019, 110 patients were randomized. Intention to treat analysis included 44 patients in the cRT arm and 45 patients in the SBRT arm. In the intervention arm, 12 patients (27%) declined SBRT and 7 patients (16%) were unable to complete the SBRT treatment. In ITT, 14/44 patients…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 45 participants or records.

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