{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:16:18Z","timestamp":1777421778096,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T00:00:00Z","timestamp":1519948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The objective of this study was to prospectively evaluate dose\u2010intensified hypofractionated stereotactic body radiation therapy (SBRT) in patients with painful spinal metastases in a multicenter, single\u2010arm, phase 2 study.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with 2 or fewer distinct, noncontiguous, painful, mechanically stable, unirradiated spinal metastases from a solid tumor with a Karnofsky performance status \u2265 60 were eligible. Patients with a long (Mizumoto score \u2264 4) or intermediate overall survival expectancy (Mizumoto score = 5\u20109) received 48.5 Gy in 10 fractions or 35 Gy in 5 fractions, respectively, with SBRT. The primary outcome was the overall (complete and partial) pain response as measured with international consensus guidelines 3 months after SBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were 57 patients enrolled between 2012 and 2015, and 54 of these patients with 60 painful vertebral metastases were analyzed. The 3\u2010month pain response was evaluated in 42 patients (47 lesions). An overall pain response was observed in 41 lesions (87%), and the pain response remained stable for at least 12 months. The mean maximum pain scores on a visual analogue scale significantly improved from the baseline of 6.1 (standard deviation, 2.5) to 2.0 (standard deviation, 2.3) 3 months after treatment (<jats:italic>P<\/jats:italic> &lt; .001). The 5\u2010level EuroQol 5\u2010Dimension Questionnaire quality\u2010of\u2010life (QOL) dimensions (self\u2010reported mobility, usual activities, and pain\/discomfort) significantly improved from the baseline to 3 months after treatment. The 12\u2010month overall survival and local control rates were 61.4% (95% confidence interval [CI], 48%\u201074.8%) and 85.9% (95% CI, 76.7%\u201095%), respectively. Grade 3 toxicity was limited to acute pain in 1 patient (2%). No patient experienced radiation\u2010induced myelopathy. Six patients (11%) developed progressive vertebral compression fractures (VCFs), and 8 patients (15%) developed new VCFs.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Dose\u2010intensified SBRT achieved durable local metastasis control and resulted in pronounced and long\u2010term pain responses and improved QOL. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:2001\u20109<\/jats:bold>. \u00a9 <jats:italic>2018 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31294","type":"journal-article","created":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T13:26:45Z","timestamp":1519997205000},"page":"2001-2009","source":"Crossref","is-referenced-by-count":30,"title":["Dose\u2010intensified hypofractionated stereotactic body radiation therapy for painful spinal metastases: Results of a phase 2 study"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7146-9071","authenticated-orcid":false,"given":"Matthias","family":"Guckenberger","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University Hospital Zurich Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhart A.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Leopoldina Hospital Schweinfurt Schweinfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Cancer Research UK\/Medical Research Council Oxford Institute for Radiation Oncology, Gray Laboratories University of Oxford Oxford United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Belderbos","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Netherlands Cancer Institute Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolaus","family":"Andratschke","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital Zurich Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merina","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Royal Marsden NHS Foundation Trust\/Institute of Cancer Research Sutton United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indira","family":"Madani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital Zurich Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Mantel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Steigerwald","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Flentje","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,2]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"CD004721","article-title":"Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy\u2014a systematic review of the randomised trials","author":"Sze WM","year":"2004","journal-title":"Cochrane Database Syst 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