An intra-patient dose-escalation study of disodium pamidronate plus radiotherapy versus radiotherapy alone for the treatment of osteolytic metastases: Monitoring of recalcification using image-processing techniques

Kouloulias, EV; Kouvaris, RJ; Antypas, C; Mystakidou, K; Matsopoulos, G; Uzunoglu, CN; Moulopoulos, A; Vlahos, JL

dc.contributor.author	Kouloulias, EV	en
dc.contributor.author	Kouvaris, RJ	en
dc.contributor.author	Antypas, C	en
dc.contributor.author	Mystakidou, K	en
dc.contributor.author	Matsopoulos, G	en
dc.contributor.author	Uzunoglu, CN	en
dc.contributor.author	Moulopoulos, A	en
dc.contributor.author	Vlahos, JL	en
dc.date.accessioned	2014-03-01T01:18:39Z
dc.date.available	2014-03-01T01:18:39Z
dc.date.issued	2003	en
dc.identifier.issn	0179-7158	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/15132
dc.relation.uri	http://www.scopus.com/inward/record.url?eid=2-s2.0-0038747965&partnerID=40&md5=719d23ed3cb0b79285c8f45505e5e167	en
dc.subject	Disodium pamidronate	en
dc.subject	Dose escalation	en
dc.subject	Image processing	en
dc.subject	Osteolytic metastases	en
dc.subject	Palliation	en
dc.subject	Radiotherapy	en
dc.subject.classification	Oncology	en
dc.subject.classification	Radiology, Nuclear Medicine & Medical Imaging	en
dc.subject.other	pamidronic acid	en
dc.subject.other	adult	en
dc.subject.other	article	en
dc.subject.other	bone mass	en
dc.subject.other	bone metastasis	en
dc.subject.other	bone radiography	en
dc.subject.other	calcification	en
dc.subject.other	cancer chemotherapy	en
dc.subject.other	cancer radiotherapy	en
dc.subject.other	clinical article	en
dc.subject.other	controlled study	en
dc.subject.other	disease association	en
dc.subject.other	dose response	en
dc.subject.other	electron	en
dc.subject.other	energy	en
dc.subject.other	female	en
dc.subject.other	histogram	en
dc.subject.other	human	en
dc.subject.other	image processing	en
dc.subject.other	male	en
dc.subject.other	morbidity	en
dc.subject.other	ossification	en
dc.subject.other	osteolysis	en
dc.subject.other	palliative therapy	en
dc.subject.other	patient monitoring	en
dc.subject.other	radiation dose	en
dc.subject.other	treatment outcome	en
dc.subject.other	treatment planning	en
dc.subject.other	weight bearing	en
dc.subject.other	Adult	en
dc.subject.other	Antineoplastic Agents	en
dc.subject.other	Bone Density	en
dc.subject.other	Bone Neoplasms	en
dc.subject.other	Bone Regeneration	en
dc.subject.other	Chemotherapy, Adjuvant	en
dc.subject.other	Combined Modality Therapy	en
dc.subject.other	Diphosphonates	en
dc.subject.other	Dose Fractionation	en
dc.subject.other	Dose-Response Relationship, Drug	en
dc.subject.other	Drug Administration Schedule	en
dc.subject.other	Female	en
dc.subject.other	Follow-Up Studies	en
dc.subject.other	Humans	en
dc.subject.other	Image Processing, Computer-Assisted	en
dc.subject.other	Infusions, Intravenous	en
dc.subject.other	Male	en
dc.subject.other	Middle Aged	en
dc.subject.other	Osteolysis	en
dc.subject.other	Particle Accelerators	en
dc.subject.other	Tomography, X-Ray Computed	en
dc.title	An intra-patient dose-escalation study of disodium pamidronate plus radiotherapy versus radiotherapy alone for the treatment of osteolytic metastases: Monitoring of recalcification using image-processing techniques	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2003	en
heal.abstract	Objective: To evalutate the clinical benefit and mainly to monitor quantitatively the recalcification of osteolytic Lesions after radiotherapy with or without intravenous infusion of disodium pamidronate (DP) in different doses. Patients and Methods: 42 patients with solitary lytic metastasis in weight-bearing bones were studied. Primary endpoints were the mean value and energy of gray-level histogram in plain radiographs (MVGLH and EGLH) and relative electron density (RED) of CT scans in bone lesions. In eleven patients (group A) the DP dose was increased stepwise from 90 up to 180 mg (flat dose), while in other 15 patients (group B) a flat dose of 180 mg was administered intravenously in 2 h. In both groups, the first session of DP was given concurrently with local radiotherapy (30 Gy in ten fractions, 5 days a week). Another 16 patients (group C) underwent radiotherapy only. Results: Morbidity related to pamidronate was mild. Significant differences from the baseline (p < 0.05, Wilcoxon test) were recorded for MVGLH, EGLH and RED values, regarding all groups. Improvement was significantly higher in patients of group B versus A, white the results of pamidronate groups (A and 13) were superior to group C, concerning the above indices (p < 0.05, Mann-Whitney test). Additionally, pamidronate groups had significantly lower skeletal morbidity than group C. Conclusion: The 2-h infusional flat dose of 180 mg every 4 weeks seems to be tolerable and superior to 90 mg regarding palliation and mainly recalcification of osteolytic Lesions. Radiotherapy alone is effective but inferior to the combined treatment. Last but not Least, the findings of MVGLH, EGLH and RED indicate an important increase in bone mass and bone formation, which was difficult to be identified visually by the experts.	en
heal.publisher	URBAN & VOGEL	en
heal.journalName	Strahlentherapie und Onkologie	en
dc.identifier.isi	ISI:000183890100006	en
dc.identifier.volume	179	en
dc.identifier.issue	7	en
dc.identifier.spage	471	en
dc.identifier.epage	479	en