Palliative radiation treatment of bone and spine metastases. In the metastatic cases; the indications for different treatments and fractionations

Cengiz Kurtman1, Iryna Sokur2, Olena Martsenius3, Julia Volokitina4, Tetiana Nesterenko5, and Mahmut Kemal Özbilgin6

1Cengiz Kurtman, ORCID NO: 0000-0001-9865-2370, MD, Prof.Dr, Ankara University Medical Faculty Department of Radiation Oncology, Ankara, Turkey, Email: kurtman@medicine.ankara.edu.tr
2Iryna Sokur, ORCID NO: 0000-0002-5299-898X, MD, Chief Doctor of Kherson Regional Oncological Center, Kherson, Ukraine, Email: irina.v.sokur@gmail.com
3Olena Martsenius, ORCID NO: 0000-0002-2728-271X, MD, Radiation Oncology Department of Kherson Regional Oncological Center, Kherson, Ukraine, Email: martsenius@ukr.net
4Julia Volokitina, ORCID NO: 0000-0002-0649-4123,MD, Radiation Oncology Department of Kherson Regional Oncological Center, Kherson, Ukraine, Email: volokitinajulija@rambler.ru
5Tetiana Nesterenko, ORCID NO: 000-0002-0649-4123, MD, Gynecology Department of Kherson Regional Oncological Center, Kherson, Ukraine, Email: tatyana.nesterenko.77@outlook.com
6Mahmut Kemal Özbilgin, ORCID NO: 0000-0001-6627-5443, MD, Prof.Dr, Celal Bayar University Medical Faculty Department of Histology and Embriology, Manisa-Turkey,
Email: kemalozbilgin@yahoo.com

ABSTRACT
Radiotherapy (RT) for bone metastases with external beam radiotherapy (EBRT) often give pain relief and may help to stop the cancer progression and compression. There are many approches to spinal vertebral bone metastase with EBRT; such as three dimensional conformal RT (3DCRT) with or without wedges, intensity modulated radiotherapy (IMRT), steriotactic body radiotherapy (SBRT), volumetric arc therapy (VMAT) and thomotherapy. Depend on the tissue tolerance the fractionated or single dose EBRT of 3Gyx10fr=30 Gy, 4Gyx6fr=24Gy, 5Gyx4fr=20 Gy, or 8Gyx1fr=8Gy should be given.The fractionated RT has greater and more prolonged relief in spine sites, but acute reactions are longer, and 8% re-treatment (2-2.5 times less then single or SBRT) and the fracture progression rare with conventional EBRT. For planning single fraction 1×8 Gy radiotherapy and multi-fraction 3×10 Gy radiotherapy, we have made many plans to give EBRT to cervical, torocal, lumbar, sacral and pelvic bone metastasis in patients with metastatic bladder and lung cancer. Single fraction for metastatic bladder cancer and 10 fractions for lung cancer were examined from different angles. As a result of the evaluation of the plans with dose volume histograms, it was found that conventional three-dimensional conformal radiotherapy planning was good for the treatment of metastatic lesions. Side effects were found to be within normal tissue tolerances. The patients received three-dimensional radiotherapy from the anterior-posterior areas for treatment. Relief and tumor control were achieved in the follow-up. Many RT planning and applications are tried and the most appropriate treatment can be performed safely within the dose limits of tumor control and normal tissue tolerances.

Key words:Radiotherapy, Bone metastases, Spine

Cite this article:
Kurtman, C., Sokur, I., Martsenius, O., Volokitina, J., Nesterenko, T., & Özbilgin, M.K. (2019). Palliative radiation treatment of bone and spine metastases. In the metastatic cases; the indications for different treatments and fractionations. European International Journal of Science and Technology, 8(9), 25-37.