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Palliative care of proximal femur metastatic disease and osteolytic lesions: results following surgical and radiation treatment

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Název: Palliative care of proximal femur metastatic disease and osteolytic lesions: results following surgical and radiation treatment
Autoři: Mehnert, Elisabeth, Möller, Fränze Sophie, Hofbauer, Christine, Weidlich, Anne, Winkler, Doreen, Troost, Esther G. C., Jentsch, Christina, Kamin, Konrad, Mäder, Marcel, Schaser, Klaus-Dieter, Fritzsche, Hagen
Zdroj: BMC Cancer
BMC Cancer, Vol 24, Iss 1, Pp 1-16 (2024)
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Adult, Proximal femoral metastasis, Bone Neoplasms, Breast Neoplasms, Osteolysis, Kaplan-Meier Estimate, Humans, Femur, RC254-282, Aged, Retrospective Studies, Aged, 80 and over, Osteolytic bone lesions, Aged, 80 and over [MeSH], Femoral Neoplasms/radiotherapy [MeSH], Radiotherapy, Adjuvant/methods [MeSH], Aged [MeSH], Prostatic Neoplasms/mortality [MeSH], Radiotherapy, Adjuvant/adverse effects [MeSH], Prostatic Neoplasms/pathology [MeSH], Femoral Neoplasms/secondary [MeSH], Breast Neoplasms/radiotherapy [MeSH], Prostatic Neoplasms/radiotherapy [MeSH], Osteolysis/etiology [MeSH], Multimodal cancer therapies, Fractures, Spontaneous/surgery [MeSH], Palliative Care/methods [MeSH], Bone Neoplasms/surgery [MeSH], Male [MeSH], Breast Neoplasms/surgery [MeSH], Prostatic Neoplasms/surgery [MeSH], Breast Neoplasms/mortality [MeSH], Breast Neoplasms/pathology [MeSH], Bone Neoplasms/radiotherapy [MeSH], Female [MeSH], Adult [MeSH], Intramedullary nailing, Kaplan-Meier Estimate [MeSH], Humans [MeSH], Fractures, Spontaneous/etiology [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Impending fracture, Skeletal-related events, Femur/surgery [MeSH], Femur/pathology [MeSH], Bone Neoplasms/secondary [MeSH], Femoral Neoplasms/mortality [MeSH], Bone Neoplasms/mortality [MeSH], Pathological fracture, Femur/radiation effects [MeSH], Research, Femoral Neoplasms/surgery [MeSH], Femoral Neoplasms, Palliative Care, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prostatic Neoplasms, Middle Aged, Fractures, Spontaneous, Female, Radiotherapy, Adjuvant
Popis: Background Femoral bone metastases (FBM) or lesions (FBL) can lead to loss of mobility and independence due to skeletal-related events (SRE), e.g. pain, deformity and pathological fractures. Aim of this study was to analyze effects of radiotherapy and surgery, different surgical techniques and complications on disease-specific survival (DSS). Methods Patients who underwent palliative therapy for FBM or FBL between 2014–2020 were retrospectively analyzed. Chi-square test was used to detect intergroup differences. Survival was calculated using Kaplan-Meier method, Cox regression and compared using log-rank test. Complications were evaluated using Chi-Square test. Results 145 patients were treated for proximal femoral BM/OBL or pathologic fractures (10 bilaterally). Three groups were classified: surgery only (S, n = 53), surgery with adjuvant radiation (S/RT, n = 58), and primary radiation only (RT, n = 44). Most common primary tumors were breast (n = 31), prostate (n = 27), and non-small cell lung cancer (n = 27). 47 patients underwent surgery for an impending, 61 for a manifest pathological fracture. There were no significant differences in DSS between the 3 groups (S = 29.8, S/RT = 32.2, RT = 27.1 months), with the S + RT group having the longest one-year survival. Local complications occurred in 25 of 145 patients after a mean interval of 9.9 months. Conclusion Due to the steadily increasing incidence and survival of patients with FBM/FBL, indication for prevention and treatment of painful and immobilizing SREs should be critically assessed. Surgical treatment should always be performed with maximum stability and, whenever possible, adjuvant RT.
Druh dokumentu: Article
Other literature type
ISSN: 1471-2407
DOI: 10.21203/rs.3.rs-4983391/v1
DOI: 10.1186/s12885-024-13170-0
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39574021
https://doaj.org/article/fb74cf610df84c17acb0bd4af2e90f3b
https://repository.publisso.de/resource/frl:6521546
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....37355bf9893dae583f716f1da4dc3d3d
Databáze: OpenAIRE
Popis
Abstrakt:Background Femoral bone metastases (FBM) or lesions (FBL) can lead to loss of mobility and independence due to skeletal-related events (SRE), e.g. pain, deformity and pathological fractures. Aim of this study was to analyze effects of radiotherapy and surgery, different surgical techniques and complications on disease-specific survival (DSS). Methods Patients who underwent palliative therapy for FBM or FBL between 2014–2020 were retrospectively analyzed. Chi-square test was used to detect intergroup differences. Survival was calculated using Kaplan-Meier method, Cox regression and compared using log-rank test. Complications were evaluated using Chi-Square test. Results 145 patients were treated for proximal femoral BM/OBL or pathologic fractures (10 bilaterally). Three groups were classified: surgery only (S, n = 53), surgery with adjuvant radiation (S/RT, n = 58), and primary radiation only (RT, n = 44). Most common primary tumors were breast (n = 31), prostate (n = 27), and non-small cell lung cancer (n = 27). 47 patients underwent surgery for an impending, 61 for a manifest pathological fracture. There were no significant differences in DSS between the 3 groups (S = 29.8, S/RT = 32.2, RT = 27.1 months), with the S + RT group having the longest one-year survival. Local complications occurred in 25 of 145 patients after a mean interval of 9.9 months. Conclusion Due to the steadily increasing incidence and survival of patients with FBM/FBL, indication for prevention and treatment of painful and immobilizing SREs should be critically assessed. Surgical treatment should always be performed with maximum stability and, whenever possible, adjuvant RT.
ISSN:14712407
DOI:10.21203/rs.3.rs-4983391/v1