Intensity Modulated Radiotherapy on Osteolytic Spinal Metastasis of Colorectal Cancer: Stability, Survival Analysis and Impact of K-RAS Mutation | ||||
| SECI Oncology Journal | ||||
| Volume 11, Issue 4, October 2023, Page 290-299 | ||||
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| Abstract | ||||
| Background: The aim of this study was to evaluate the impact of intensity- modulated radiotherapy in terms of spinal stability as well as survival and related prognostic factors in colorectal cancer with bone metastases. Methods: A prospective multi-center analysis of fifty-nine patients with colorectal cancer and spinal bone metastases were treated in the period from April 2019 and June 2022. The stability was assessed by using the Taneichi score before, 3, and 6 months after radiotherapy. Additionally, prognostic factors for stability and overall survival were assessed. Results: Before radiotherapy 71.2% of patients were unstable and 6 months after RT 60% of pts were stable. After 6 months, only 10% (n=3) of the originally unstable spinal bone metastasis patients were reclassified as stable. So predictive factors for stability couldn’t be assessed. Mean bone survival in our study was 7.49 (95% CI 6.29-8.68). Four characteristics had a significant impact on survival in univariate analysis: kps>70, bisphosphonate, chemotherapy therapy, and gene mutation and extraosseous metastases (p<0.001). Conclusions: Intensity modulated radiotherapy is associated with poor stability of osteolytic spinal metastases from colorectal cancer. Survival in patients with bone metastases from colorectal cancer remains poor. Performance state, chemotherapy, bisphosphonate, and gene mutation be a predictor for the response, with no difference regarding survival and stability from conformal 3D radiotherapy. | ||||
| Keywords | ||||
| Bone metastases; Spine; colorectal cancer; Stability; IMRT | ||||
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