ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2025
Evaluating risk factors for skeletal-related events among bone metastases from solid tumors.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
background and purposeSkeletal-related events (SRE) are a major source of morbidity and mortality across cancer types. Identification of risk factors for SRE and association with survival would facilitate more targeted preventive treatment. MATERIALS AND
methodsThis retrospective cohort study included patients with bone metastases from solid tumors undergoing systemic imaging from February-March 2022 who had not received radiation within one year. Survival was analyzed using Cox models, and multi-state models assessed factors linked to SRE with death as a competing risk. Outcomes were SRE (including radiation for pain) and all-cause death. Variables included tumor type, metastasis site, and trial eligibility.
resultsAmong 410 patients (median age 67 years; 48% male), 162 (40%) experienced SRE over a median follow-up of 26.8 months. Seventy-five (18%) received radiation for pain alone. Experiencing any type of SRE (HR 1.98, 95% CI 1.47 - 2.67, p<0.001) or radiation for pain alone (HR 2.14, 95% CI 1.57 - 2.92, p<0.001) were both associated with increased mortality. Patients eligible for a trial of early radiation were more likely to develop SRE (HR 1.67, 95% CI 1.18 - 2.37, p=0.004). Prostate cancer histology (HR 1.70, p=0.02) and metastases to the hip/acetabulum (HR 2.55, p=0.02) were associated with SRE.
conclusionPatients treated with radiation for pain alone demonstrated similar risk of death as those experiencing any type of SRE, supporting the inclusion of radiation in endpoint definitions. Prostate cancer type and hip/acetabulum metastasis location may help identify patients and lesions at elevated SRE risk, informing future preventive strategies.
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