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@ARTICLE{Rhle:181614,
      author       = {A. Rühle$^*$ and V. A. Nya Yompang$^*$ and S. K. B.
                      Spohn$^*$ and R. Stoian$^*$ and C. Zamboglou$^*$ and E.
                      Gkika$^*$ and A.-L. Grosu$^*$ and N. Nicolay$^*$ and T.
                      Sprave$^*$},
      title        = {{P}alliative radiotherapy of bone metastases in
                      octogenarians: {H}ow do the oldest olds respond? {R}esults
                      from a tertiary cancer center with 288 treated patients.},
      journal      = {Radiation oncology},
      volume       = {17},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2022-02114},
      pages        = {153},
      year         = {2022},
      note         = {#LA:E055#},
      abstract     = {Accompanied by the demographic change, the number of
                      octogenarian cancer patients with bone metastases will
                      increase in the future. Palliative radiotherapy constitutes
                      an effective analgesic treatment; however, as pain
                      perception and bone metabolism change with increasing age,
                      the analgesic efficacy of radiotherapy may be altered in
                      elderly patients. We therefore investigated the treatment
                      outcomes of palliative radiotherapy for bone metastases in
                      octogenarians.Patients between 80 and 89 years undergoing
                      radiotherapy for bone metastases between 2009 and 2019 at a
                      tertiary cancer center were analyzed for patterns-of-care,
                      pain response and overall survival (OS). Logistic regression
                      analyses were carried out to examine parameters associated
                      with pain response, and Cox analyses were conducted to
                      reveal prognostic parameters for OS.A total of 288 patients
                      with 516 irradiated lesions were included in the analysis.
                      The majority (n = 249, $86\%)$ completed all courses of
                      radiotherapy. Radiotherapy led to pain reduction in 176
                      patients $(61\%)$ at the end of treatment. Complete pain
                      relief at the first follow-up was achieved in 84 patients
                      $(29\%).$ Bisphosphonate administration was significantly
                      associated with higher rates of pain response at the first
                      follow-up (p < 0.05). Median OS amounted to 9 months, and
                      1-year, 2-year and 3-year OS were $43\%,$ $28\%$ and $17\%.$
                      In the multivariate analysis, ECOG (p < 0.001), Mizumoto
                      score (p < 0.01) and Spinal Instability Neoplastic Score
                      (SINS) (p < 0.001) were independent prognosticators for
                      OS.Palliative radiotherapy for bone metastases constitutes a
                      feasible and effective analgesic treatment in octogenarian
                      patients. ECOG, Mizumoto score and SINS are prognosic
                      variables for survival and may aid treatment decisions
                      regarding radiotherapy fractionation in this patient group.
                      Single-fraction radiotherapy with 8 Gy should be applied for
                      patients with uncomplicated bone metastases and poor
                      prognosis. Prospective trials focusing on quality of life of
                      these very old cancer patients with bone metastases are
                      warranted to reveal the optimal radiotherapeutic management
                      for this vulnerable population.},
      keywords     = {Bone metastases (Other) / Elderly (Other) / Geriatric
                      (Other) / Octogenarians (Other) / Radiotherapy (Other) /
                      SINS (Other)},
      cin          = {FR01 / E055},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36071522},
      doi          = {10.1186/s13014-022-02122-2},
      url          = {https://inrepo02.dkfz.de/record/181614},
}