Does kV Image Guidance for Bone Metastases Improve Pain Control?
Ahmet S Tunceroglu1,2, Bin Gui2, Shou-En Lu3
1Department of Radiation Oncology, Metro Health Cancer Center, University of Michigan, Wyoming, MI, United States.
Frontiers in Oncology
|July 5, 2021
Summary
Kilovoltage (kV) image guidance improves pain control for bone metastases, especially in the lower extremities and with extra-osseous disease. This technique enhances patient setup and therapeutic efficacy.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Kilovoltage (kV) image guidance is widely available but its use in treating painful bone metastases varies.
- Factors influencing kV image guidance adoption include perceived setup adequacy and practice patterns.
Purpose of the Study:
- To evaluate the impact of kilovoltage (kV) image guidance on therapeutic efficacy in treating painful bone metastases.
- To determine if kV image guidance improves pain reduction in patients with osseous metastases.
Main Methods:
- Retrospective review of 164 patients with 257 painful bone metastases treated with radiation therapy.
- Generalized estimating equation (GEE) logistic regression analyses were used to assess pain reduction correlations.
- Univariate and multivariate analyses examined the association between kV image guidance and pain relief.
Main Results:
- Median time to pain reduction was 3 days; 77% of lesions had ≥50% pain reduction, and 53% achieved complete pain relief.
- Non-small cell lung cancer metastases and extra-osseous disease extension were associated with less pain relief.
- kV image guidance correlated with improved pain control for lower extremity metastases (p=0.03) and fewer treatment fractions (p=0.01), especially with extra-osseous disease (p=0.003).
Conclusions:
- Kilovoltage image guidance may enhance pain control for painful bone metastases.
- Improved patient setup via kV image guidance is particularly beneficial for lower extremity tumors, extraosseous disease, and shorter treatment courses.
