Remineralisation after Palliative Radiotherapy and its Effect on SINS and Pain Response

Abstract

Introduction Spinal metastases, occurring in up to 40% of cancer patients, often lead to instability and pain. This study examines the effects of palliative radiotherapy (RT) on bone remineralisation, spinal instability (SINS scores), and pain response.

Methods Data from the PRESENT cohort were used, focusing on patients with osteolytic or mixed bone metastases from specific primary cancers. Bone mineral density (BMD) in Hounsfield Units (HU), SINS scores, and pain responses were measured before and after RT. Statistical analyses included paired T-tests, Kendall’s tau B correlation, and Fisher’s exact test.

Results Twelve patients met the criteria. Mean BMD slightly decreased from 105.8 HU to 100.4 HU (p = 0.435). However, 33% of patients showed significant remineralisation. An inverse relationship between BMD changes and SINS scores (correlation coefficient = -0.490, p = 0.037) suggested improved stability. No significant link was found between remineralisation and pain response (p = 0.228).

Conclusion RT had a minimal overall effect on remineralisation in our cohort, with no significant impact on pain relief. While increased BMD might correlate with improved spinal stability presented in a decreased SINS score, further standardised studies are needed to understand the clinical benefits of remineralisation in spinal metastases.