Randomized trials have established that single-fraction radiation to a previously unirradiated, uncomplicated peripheral bone or vertebral metastasis provides comparable pain relief and morbidity compared to multiple-fraction regimens, while optimizing patient and caregiver convenience. Although it results in a higher incidence of retreatment at a later date (20% vs. 8 % for multi-fraction regimens), the decreased patient burden usually outweighs any considerations of long-term effectiveness for those with a limited life expectancy.

Conditions: Cancer, Malignancy, Tumor, Bone Metastasis

Treatments: Palliative Radiation, Radiotherapy

Sources

• Fairchild A, Barnes E, Ghosh S, et al. International patterns of practice in palliative radiotherapy for painful bone metastases: evidence-based practice? Int. J. Radiat. Oncol. Biol. Phys. Dec 1 2009;75(5):1501-1510. (PubMed)
• Lutz S, Berk L, Chang E, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int. J. Radiat. Oncol. Biol. Phys. Mar 15 2011;79(4):965-976. (PubMed)
• Popovic M, den Hartogh M, Zhang L, et al. Review of international patterns of practice for the treatment of painful bone metastases with palliative radiotherapy from 1993 to 2013. Radiother. Oncol. Apr 2014;111(1):11-17. (PubMed)
• Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. May 17 2014;383(9930):1721-1730. (PubMed)