- 作者：Naoki Nakamura ; M.D.&lowast ; ; naokinak@luke.or.jp ; Naoto Shikama ; M.D.&dagger ; ; Hitoshi Wada ; M.D.&Dagger ; ; Hideyuki Harada ; M.D.§ ; ; Miwako Nozaki ; M.D.¶ ; ; Hisayasu Nagakura ; M.D.?/sup> ; Masao Tago ; M.D.&lowast ; &lowast ; ; Masahiko Oguchi ; M.D.&dagger ; &dagger ; ; Nobue Uchida ; M.D.&Dagger ; &Dagger ; ; Japanese Radiation Oncology Study Group Working Subgroup of Palliative Radiotherapy
- 关键词：Radiotherapy ; Bone metastasis ; Japan ; Single fraction ; Oligometastasis
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 May, 2012
- 年：2012
- 卷：83
- 期：1
- 页码：e117-e120
- 全文大小：146 K
Purpose
To determine the current patterns of practice in Japan and to investigate factors that may make clinicians reluctant to use single-fraction radiotherapy (SF-RT).Methods and Materials
Members of the Japanese Radiation Oncology Study Group (JROSG) completed an Internet-based survey and described the radiotherapy dose fractionation they would recommend for four hypothetical cases describing patients with painful bone metastasis (BM). Case 1 described a patient with an uncomplicated painful BM in a non-weight-bearing site from non-small-cell lung cancer. Case 2 investigated whether management for a case of uncomplicated spinal BM would be different from that in Case 1. Case 3 was identical with Case 2 except for the presence of neuropathic pain. Case 4 investigated the prescription for an uncomplicated painful BM secondary to oligometastatic breast cancer. Radiation oncologists who recommended multifraction radiotherapy (MF-RT) for Case 2 were asked to explain why they considered MF-RT superior to SF-RT.
Results
A total of 52 radiation oncologists from 50 institutions (36 % of JROSG institutions) responded. In all four cases, the most commonly prescribed regimen was 30 Gy in 10 fractions. SF-RT was recommended by 13 % of respondents for Case 1, 6 % for Case 2, 0 % for Case 3, and 2 % for Case 4. For Case 4, 29 % of respondents prescribed a high-dose MF-RT regimen (e.g.,?50?Gy in 25 fractions). The following factors were most often cited as reasons for preferring MF-RT: ¡°time until first increase in pain?(85 % ), ¡°incidence of spinal cord compression?(50 % ), and ¡°incidence of pathologic fractures?(29 % ).
Conclusions
Japanese radiation oncologists prefer a schedule of 30 Gy in 10 fractions and are less likely to recommend SF-RT. Most Japanese radiation oncologists regard MF-RT as superior to SF-RT, based primarily on the time until first increase in pain.