Comparative Analyses of Two Established Scores to Assess the Stability of Spinal Bone Metastases Before and After Palliative Radiotherapy.

SINS instability radiotherapy skeletal-related events spinal bone metastases

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2021
Historique:
received: 05 08 2021
accepted: 21 09 2021
entrez: 5 11 2021
pubmed: 6 11 2021
medline: 6 11 2021
Statut: epublish

Résumé

To compare two validated spinal instability scores regarding the stabilizing effects and skeletal-related events (SREs) of palliative radiotherapy (RT) in patients with spinal bone metastases (SBM). Two hundred eighty-two osteolytic SBM of lung or breast cancer patients were analyzed for stability before and following RT based on the Spinal Instability Neoplastic Score (SINS) or the Taneichi score. Score concordance was quantified by absolute agreement and Cohen's kappa coefficient. SREs were defined as fractures or local progression after RT. OS was quantified as the time between the start of RT and death from any cause. At 3 and 6 months after RT, 35 and 50% of initially unstable SBM were re-stabilized according to SINS in patients still alive. Corresponding Taneichi score-based stabilization proportions were 25 and 46%, respectively. Comparison of both stability scores showed high absolute agreement for all time-points (range 71-78%, kappa range 0.35-0.44). SRE occurred more frequently in initially unstable SBM compared to stable SBM according to SINS (14 Despite the relatively high agreement between both stabilization scores, the SINS should be considered the standard for future studies on the stabilization effects of RT in SBM.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
To compare two validated spinal instability scores regarding the stabilizing effects and skeletal-related events (SREs) of palliative radiotherapy (RT) in patients with spinal bone metastases (SBM).
MATERIALS AND METHODS METHODS
Two hundred eighty-two osteolytic SBM of lung or breast cancer patients were analyzed for stability before and following RT based on the Spinal Instability Neoplastic Score (SINS) or the Taneichi score. Score concordance was quantified by absolute agreement and Cohen's kappa coefficient. SREs were defined as fractures or local progression after RT. OS was quantified as the time between the start of RT and death from any cause.
RESULTS RESULTS
At 3 and 6 months after RT, 35 and 50% of initially unstable SBM were re-stabilized according to SINS in patients still alive. Corresponding Taneichi score-based stabilization proportions were 25 and 46%, respectively. Comparison of both stability scores showed high absolute agreement for all time-points (range 71-78%, kappa range 0.35-0.44). SRE occurred more frequently in initially unstable SBM compared to stable SBM according to SINS (14
CONCLUSIONS CONCLUSIONS
Despite the relatively high agreement between both stabilization scores, the SINS should be considered the standard for future studies on the stabilization effects of RT in SBM.

Identifiants

pubmed: 34737961
doi: 10.3389/fonc.2021.753768
pmc: PMC8562722
doi:

Types de publication

Journal Article

Langues

eng

Pagination

753768

Informations de copyright

Copyright © 2021 Bostel, Akbaba, Wollschläger, Klodt, Oebel, Mayer, Drabke, Sprave, Debus, Förster, Rief, Rühle, Grosu, Schmidberger and Nicolay.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Tilman Bostel (T)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Sati Akbaba (S)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Daniel Wollschläger (D)

Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany.

Tristan Klodt (T)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Laura Oebel (L)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Arnulf Mayer (A)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Sophia Drabke (S)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Tanja Sprave (T)

Department of Radiation Oncology, University Hospital of Freiburg, Freiburg, Germany.
German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center, Heidelberg, Germany.

Jürgen Debus (J)

Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
German Cancer Consortium (DKTK) Partner Site Heidelberg, German Cancer Research Center, Heidelberg, Germany.

Robert Förster (R)

Institute of Radiation Oncology, Cantonal Hospital Winterthur, University of Zurich, Winterthur, Switzerland.

Harald Rief (H)

Radiation Therapy Practice Bonn-Rhein-Sieg, Bad Godesberg site, Bonn, Germany.

Alexander Rühle (A)

Department of Radiation Oncology, University Hospital of Freiburg, Freiburg, Germany.
German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center, Heidelberg, Germany.

Anca-Ligia Grosu (AL)

Department of Radiation Oncology, University Hospital of Freiburg, Freiburg, Germany.
German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center, Heidelberg, Germany.

Heinz Schmidberger (H)

Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany.
German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center, Heidelberg, Germany.

Nils H Nicolay (NH)

Department of Radiation Oncology, University Hospital of Freiburg, Freiburg, Germany.
German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center, Heidelberg, Germany.

Classifications MeSH