Quality of life and pain-response after stereotactic ablative radiotherapy of oligometastatic bone metastases in the phase 2 BONY-M trial.
Nicklas Juel Spindler, Sebastian Moretto Krog, Mette van Overeem Felter et al.
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In 30 seconds
This phase 2 multicentre trial evaluated longitudinal health-related quality of life (HRQoL) and pain response after stereotactic ablative radiotherapy (SABR) for bone metastases in patients with oligometastatic disease. Among 67 analysed patients, mean EQ-5D-5L index and visual analogue scale scores remained stable through 52 weeks. In the 22 patients symptomatic at baseline, overall pain response was 59% (13/22) at 24 weeks and 41% (9/22) at 52 weeks; mean pain score decreased by 2.4 points (95% CI: 1.6-3.3) at 24 weeks. Pain flare at week 2 occurred in 11% (7/66).
Key findings
- Mean EQ-5D-5L index and visual analogue scale scores remained stable through 52 weeks of follow-up.
- Among symptomatic patients, overall pain response was 59% (13/22) at 24 weeks and 41% (9/22) at 52 weeks.
- Mean pain score among symptomatic patients decreased by 2.4 points (95% CI: 1.6-3.3) at 24 weeks.
- Pain flare at week 2 occurred in 11% (7/66) of patients.
Why it matters
For selected patients with oligometastatic bone disease, local SABR may provide pain relief without an observed decline in average HRQoL over one year. The findings also show that baseline symptoms distinguish patients’ reported pain and HRQoL, supporting attention to symptom status when interpreting outcomes. Pain flare occurred in a minority of patients early after treatment.
What to keep in mind
This was a phase 2 trial, and the reported HRQoL and pain analyses were secondary endpoints. Follow-up for these outcomes was limited to 52 weeks.