Radiotherapy in conjunction with intravenous infusion of 180 mg of disodium pamidronate in management of osteolytic metastases from breast cancer: Clinical evaluation, biochemical markers, quality of life, and monitoring of recalcification using assessments of gray-level histogram in plain radiographs

Kouloulias, V; Matsopoulos, G; Kouvaris, J; Dardoufas, C; Bottomley, A; Varela, M; Uzunoglu, N; Antypas, C; Metafa, A; Moulopoulos, A; Sandilos, P; Vlahos, L

dc.contributor.author	Kouloulias, V	en
dc.contributor.author	Matsopoulos, G	en
dc.contributor.author	Kouvaris, J	en
dc.contributor.author	Dardoufas, C	en
dc.contributor.author	Bottomley, A	en
dc.contributor.author	Varela, M	en
dc.contributor.author	Uzunoglu, N	en
dc.contributor.author	Antypas, C	en
dc.contributor.author	Metafa, A	en
dc.contributor.author	Moulopoulos, A	en
dc.contributor.author	Sandilos, P	en
dc.contributor.author	Vlahos, L	en
dc.date.accessioned	2014-03-01T01:19:28Z
dc.date.available	2014-03-01T01:19:28Z
dc.date.issued	2003	en
dc.identifier.issn	0360-3016	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/15513
dc.subject	Disodium pamidronate	en
dc.subject	EORTC QLQ-C30 quality-of-life questionnaire	en
dc.subject	Image-processing techniques	en
dc.subject	Osteolytic metastases	en
dc.subject	Prognostic factors	en
dc.subject	Radiotherapy	en
dc.subject.classification	Oncology	en
dc.subject.classification	Radiology, Nuclear Medicine & Medical Imaging	en
dc.subject.other	Breast cancers	en
dc.subject.other	Biochemistry	en
dc.subject.other	Diseases	en
dc.subject.other	Image processing	en
dc.subject.other	Radiography	en
dc.subject.other	Radiotherapy	en
dc.subject.other	Oncology	en
dc.subject.other	alkaline phosphatase bone isoenzyme	en
dc.subject.other	calcium	en
dc.subject.other	creatinine	en
dc.subject.other	hydroxyproline	en
dc.subject.other	pamidronic acid	en
dc.subject.other	paracetamol	en
dc.subject.other	arthralgia	en
dc.subject.other	article	en
dc.subject.other	asthenia	en
dc.subject.other	bone metastasis	en
dc.subject.other	bone pain	en
dc.subject.other	bone radiography	en
dc.subject.other	breast cancer	en
dc.subject.other	calcium urine level	en
dc.subject.other	cancer chemotherapy	en
dc.subject.other	cancer radiotherapy	en
dc.subject.other	chill	en
dc.subject.other	clinical article	en
dc.subject.other	clinical trial	en
dc.subject.other	controlled clinical trial	en
dc.subject.other	controlled study	en
dc.subject.other	creatinine urine level	en
dc.subject.other	female	en
dc.subject.other	flu like syndrome	en
dc.subject.other	follow up	en
dc.subject.other	heart arrhythmia	en
dc.subject.other	heart palpitation	en
dc.subject.other	histogram	en
dc.subject.other	human	en
dc.subject.other	hydroxyproline urine level	en
dc.subject.other	hypercalcemia	en
dc.subject.other	hypocalcemia	en
dc.subject.other	hypophosphatemia	en
dc.subject.other	linear accelerator	en
dc.subject.other	multimodality cancer therapy	en
dc.subject.other	multivariate analysis	en
dc.subject.other	myalgia	en
dc.subject.other	osteolysis	en
dc.subject.other	phase 1 clinical trial	en
dc.subject.other	phase 2 clinical trial	en
dc.subject.other	priority journal	en
dc.subject.other	quality of life	en
dc.subject.other	questionnaire	en
dc.subject.other	radiation dose	en
dc.subject.other	rank sum test	en
dc.subject.other	side effect	en
dc.subject.other	statistical significance	en
dc.subject.other	Adult	en
dc.subject.other	Aged	en
dc.subject.other	Bone Neoplasms	en
dc.subject.other	Breast Neoplasms	en
dc.subject.other	Combined Modality Therapy	en
dc.subject.other	Diphosphonates	en
dc.subject.other	Female	en
dc.subject.other	Follow-Up Studies	en
dc.subject.other	Humans	en
dc.subject.other	Infusions, Intravenous	en
dc.subject.other	Middle Aged	en
dc.subject.other	Quality of Life	en
dc.subject.other	Radiographic Image Interpretation, Computer-Assisted	en
dc.subject.other	Treatment Outcome	en
dc.title	Radiotherapy in conjunction with intravenous infusion of 180 mg of disodium pamidronate in management of osteolytic metastases from breast cancer: Clinical evaluation, biochemical markers, quality of life, and monitoring of recalcification using assessments of gray-level histogram in plain radiographs	en
heal.type	journalArticle	en
heal.identifier.primary	10.1016/S0360-3016(03)00525-X	en
heal.identifier.secondary	http://dx.doi.org/10.1016/S0360-3016(03)00525-X	en
heal.language	English	en
heal.publicationDate	2003	en
heal.abstract	Purpose: To evaluate the clinical improvement and radiographically monitor the effect of local radiotherapy in conjunction with disodium pamidronate (DP) on metastatic osteolytic disease. Methods and Materials: Thirty-three patients with osteolytic metastasis from advanced breast cancer received radiotherapy with a 6-MV linear accelerator up to a dose of 30 Gy (3 Gy/fraction, 5 d/wk) combined with 24 monthly sessions of a 180-mg DP infusion. Conventional X-rays were obtained during the first six sessions of DP treatment, retaining the same settings for each exposure. The analysis of the image attributes was based on measuring the first-order statistics of the mean value and energy of gray-level histograms in the osteolytic region. Results: The 6-month measurements compared with baseline showed statistically significant differences (p < 0.01, Wilcoxon test) in energy of gray-level histogram (-10.8%), mean value of gray-level histogram (+9.5%), pain score (-5.8 points), Eastern Cooperative Oncology Group status (-2.4 points), urine hydroxyproline/creatinine ratio (-41.7%), urine calcium/creatinine ratio (-58.8%), and bone alkaline phosphatase (-42.4%). Quality of life as determined by the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (version 3) also improved. During follow-up, 88% of patients had complete and 12% partial responses (International Union Against Cancer radiologic criteria). On multivariate analysis, greater changes in the mean value of the gray-level histogram and negative nodal status were predictors for a reduction in the number of skeletal complications after therapy. Flu-like syndrome occurred in 13 patients (39%) and was well managed with mild antipyretics. Conclusion: Image-processing in plain radiographs offers an objective way to assess recalcification. The image-processing indexes, along with the measurements of performance status, quality of life, and biochemical markers, improved significantly. Local radiotherapy combined with long-term high-dose DP up to 180 mg is tolerable and has a high therapeutic response. (C) 2003 Elsevier Inc.	en
heal.publisher	ELSEVIER SCIENCE INC	en
heal.journalName	International Journal of Radiation Oncology Biology Physics	en
dc.identifier.doi	10.1016/S0360-3016(03)00525-X	en
dc.identifier.isi	ISI:000184676100024	en
dc.identifier.volume	57	en
dc.identifier.issue	1	en
dc.identifier.spage	143	en
dc.identifier.epage	157	en