Single Arm Phase II Study of Fractionated Stereotatic Radiation Therapy (FSRT) for Bone Metastases in Breast Cancer

Recruitment & Eligibility

Inclusion Criteria

Diagnosis of invasive breast cancer
Signed informed consent
Bone metastases (confirmed by MRI within 4 weeks of enrollment).
Paraosseous soft tissue ≤ 5cm. The tumour could involve the vertebral column, but did not have to, nor did it need to enter the spinal canal.
KPS ≥ 40 or ECOG 0-2.
The tumor is at least 2 mm away from the spinal cord. If the tumor is closer than 2 mm, surgical resection is required prior to FSRT or the total prescription dose of spinal cord is strictly limited.
Failure of previous conventional external beam radiotherapy or surgery, residual tumor after surgery, medical inoperability, and refusal to undergo surgery.
A maximum of three distinct noncontiguous spinal metastases per patient was allowed, and each of the separate sites may have involvement of 2 contiguous vertebral bodies.
Patients have sufficient bone marrow reserve and liver and kidney function: neutrophil count ≥ 1500 cells / mm3; platelet count ≥ 70000 / mm3; hemoglobin (Hgb) ≥ 8.0 g / dl; if there is liver metastasis, AST and ALT < 3x ULN
The interval between systemic chemotherapy is more than 2 weeks, and the side effects recovery from previous treatment ≤ grade 1
Patients receiving bisphosphonates, endocrine or targeted therapy at the same time were not included

Exclusion Criteria

Patients with mechanically unstable spine or epidural spinal cord compression were excluded; however, patients with previously documented spinal cord compression that had been decompressed and stabilized were eligible. Patients with > 50% loss of vertebral body height were excluded.
Patients in whom a delay in initiating treatment might have adversely affected neurological outcome.
Patients with a pacemaker, unable to undergo MR imaging and unable to lie flat for at least 30 minutes.
Patients who had a history of previous radiotherapy to the spine at the current level of interest.
Patients who had received prior external-beam irradiation to the spine within 3 months of registration.
Patients who had received systemic radiotherapy (Strontium-89) within 30 days of starting protocol treatment.
Patients who had received chemotherapy within 2 weeks of starting protocol treatment.
Patients who are unwilling or unable to receive regular follow-up.
The patients judged by the researchers who could not be included in some special cases.
Serious complications: cardiovascular disease, end-stage renal disease, serious liver disease, infection, et al.
Pregnant women.

Study & Design

Arm && Interventions

Group	Intervention	Description
Fractionated Stereotatic Radiation Therapy	Fractionated Stereotatic Radiation Therapy	-

Primary Outcome Measures

Name	Time	Method
Local Control Rate	3 years	Determine the local control rate of FSRT in patients with bone metastasis of breast cancer

Secondary Outcome Measures

Name	Time	Method
Pain Control	3 years	Evaluate whether FSRT improves pain control as measured by Brief Pain Inventory (BPI) after FSRT in patients with spinal metastasis of breast cancer
Progression Free Survival	3 years	Time from the date of radiotherapy to the investigator-determined date of progression or death due to any cause, whichever occurs first
Vertebral Fracture and Radiation Myelitis	3 years	Determine the incidence of bone fracture and radiation myelitis
Overall Survival	3 years	Time from the date of informed consent until to the date of death, regardless of the cause of death
Quality of Life	3 years	Evaluate the quality of life according to EORTC QLQ-BM22

Recruitment & Eligibility