Copenhagen, Denmark

ESTRO 2022

Session Item

Mixed sites/palliation
Poster (digital)
Single fraction Lumbopelvic Bone Irradiation with Helical Tomotherapy for metastatic bone disease
Beatriz Gil Haro, Spain


Single fraction Lumbopelvic Bone Irradiation with Helical Tomotherapy for metastatic bone disease

Beatriz Gil Haro1, Sofía Santana Jiménez1, Jesús Romero Fernández1, Rafael Molerón Mancebo2, Raquel Benlloch Rodríguez1, Marta López Valcárcel1, María Hernández Miguel1, Irma Zapata Paz1, Ruth Rodríguez Romero3, Lucía Paisán Palacio1, Alfonso Valcárcel Díaz1, Patricia Sarrión Rubio de la Torre1

1Puerta de Hierro University Hospital, Radiation Oncology, Madrid, Spain; 2Aberdeen Royal Infirmary NHS Grampian, Radiation Oncology, Aberdeen, United Kingdom; 3Puerta de Hierro University Hospital, Radiophysics, Madrid, Spain

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Purpose or Objective

To assess the effectiveness and toxicity of single-fraction Lumbopelvic Bone Irradiation (LPBI) with Helical Tomotherapy (HT) in patients with widespread painful bone metastases.

Material and Methods

Between May-2010 and Aug-2021, twenty-eight patients were treated with LPBI in our institution. Clinical characteristics:  17 males, 11 females; mean age: 65 yo (32-85). Most frequent primary tumors were prostate (10) and lung (9) adenocarcinoma. Radiation-therapy: PTV included all bones from the middle-third of the femur to D9-L4 (depending on the extent of disease) plus 5 mm symmetrical margin. A single-dose of 8 Gy was administered to all patients except 2 patients who had received prior irradiation in whom 6.5 Gy was administered. Patients were premedicated with 8 mg dexamethasone, 8 mg ondansetron and 500 cc saline-solution. Subjective pain relief and pain level (Visual Analog Scale–VAS) were evaluated.

Statistics: Student’s-T-test.


Median follow-up: 7 months (0-49). Pain relief: 26 patients. Mean VAS-score (at 3-weeks postradiotherapy), decreased from 6.39 (4-9) to 2.54 (0-7) (p < 0.001). In most of patients, the tolerance was mild (CTCAEv5.0-criteria). One patient suffered a tumor-lysis-syndrome after radiotherapy that was resolved with pharmacotherapy. None of 28 patients presented GU toxicity. Grade 1-2 toxicities were asthenia (8 patients), nausea (5 patients) and hematologic (10 patients). Only one grade 3 lymphopenia was observed. One- and two-years OS were 24% and 12%, respectively (Figure 1).

Mean PTV: 3510cc (1934-7178cc). Mean V95: 93.2% (80-100%). Mean D95: 7.4 Gy (6-8.2Gy). Mean homogeneity index_RTOG: 1.08(1.01–1.15). Doses to OAR are shown in Figure 2.




LPBI with HT is a promising new high-conformal-technique very effective in the treatment of widespread bone metastases with excellent tolerance rates.