Which Type of Radiation Is Best for Painful Spots of Cancer in Spine?
Dose-intensified stereotactic radiation, which is a special type of external radiation, eased cancer-related spine pain better than traditional external radiation. The study was published in the journal Cancer.
Key takeaways
Six months after radiation treatment for the spinal metastases, (cancer that started in another part of their body and spread to spine) people who received dose-intensified stereotactic body radiation had less pain than people who received traditional external beam radiation.
Nearly twice as many people who received traditional external beam radiation said their pain got worse six months after treatment compared with people who received dose-intensified stereotactic body radiation.
This was a small study, involving 63 people with painful spinal metastases; nine of these people had breast cancer that had spread.
What the results mean for you
Although this study was small and only 15.5% of the people in the study had breast cancer, it does suggest that dose-intensified stereotactic body radiation can control the pain caused by metastatic cancer lesions in the spine better than traditional external beam radiation therapy. This is likely because stereotactic radiation can deliver a higher dose of radiation without damaging nearby organs than traditional external beam radiation.
If you’ve been diagnosed with metastatic breast cancer and have painful lesions in your spine, you may want to ask your doctor if stereotactic radiation therapy makes sense for your unique situation.
About the study
Cancer that spreads to the spine can be very painful. Early studies on stereotactic body radiation to treat painful spine metastases suggested that it could control pain. The researchers who did this study wanted to see if stereotactic radiation controlled pain better than traditional external beam radiation.
The people in the study were being treated at cancer centers in Switzerland, Belgium, Germany, Italy, and Poland.
Among the people in the study:
about 62% were men
33% were diagnosed with lung cancer
17.5% were diagnosed with prostate cancer
15.5% were diagnosed with breast cancer
Half of the people received dose-intensified stereotactic body radiation and the other half received traditional external beam radiation.
A Gray is the measure of a dose of radiation.
People who received dose-intensified stereotactic body radiation received two dose levels delivered at the same time, either:
a total of 48.5 Gray and 30 Gray given in 10 treatments on the same day
a total of 40 Gray and 20 Gray given in five treatments on the same day
People who received traditional external beam radiation received either:
a total of 20 Gray in five treatments, one per day
a total of 30 Gray in 10 treatments, one per day
When the people joined the study, they filled out a questionnaire that asked them to rate their spinal pain on a scale of zero to 10, with zero being no pain and 10 being the most severe pain. They filled out the same questionnaire six months after radiation treatment was completed.
Detailed results
The final analysis included 58 people diagnosed with metastatic cancer who had painful spinal lesions after several people dropped out of the study.
Before any radiation treatment, average pain scores were:
5.6 in the dose-intensified stereotactic body radiation group; 81.8% of this group had moderate-to-severe pain
4.6 in the traditional external beam radiation group; 56.7% of this group had moderate-to-severe pain
Six months after treatment, 69.4% of people who received dose-intensified stereotactic body radiation had their pain scores go down by two or more points compared with 41.9% of the people who received traditional external beam radiation.
People who received stereotactic radiation were much less likely to have their pain get worse six months after treatment: 22.2% of people who received dose-intensified stereotactic body radiation reported that their pain had worsened compared with 41.9% of people who received traditional external beam radiation.
Side effects other than pain were about the same no matter which type of radiation the people received and no one had a severe side effect.
“For patients who have cancer with painful vertebral metastases, dose-intensified stereotactic body radiation improved pain scores more effectively than conventional external beam radiation at six months without increasing toxicity,” the researchers concluded.
Guckenberger M, Billiet C, Schnell D, et al. Dose-intensified stereotactic body radiotherapy for painful vertebral metastases: A randomized phase 3 trial. Cancer. 2024; 1-10.
— Last updated on December 27, 2024 at 6:57 PM