MedicalResearch.com Interview with:
Quynh-Nhu Nguyen, MD
Department of Radiation Oncology
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases.
The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy) single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen. This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases. This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates. This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients. This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy.
MedicalResearch.com: What should readers take away from your report?
Response: With the availability of better systemic therapy including targeted and immunotherapy, patients with metastatic disease are surviving longer, therefore a greater need for better local control. Higher Single fraction dose of 12 or 16 Gy should be the new standard radiotherapy regimen for patients with painful bone metastases for more significant durable palliation of pain and local control.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We are working on a novel Phase III randomized trial integrating our results from this Phase II trial to continue to demonstrate better outcome and quality of life for our patients with bone metastases.
Nguyen Q, Chun SG, Chow E, et al. Single-Fraction Stereotactic vs Conventional Multifraction Radiotherapy for Pain Relief in Patients With Predominantly Nonspine Bone Metastases: A Randomized Phase 2 Trial. JAMA Oncol. Published online April 25, 2019. doi:10.1001/jamaoncol.2019.0192
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