Radiation therapy for palliation of bone metastases

Roman Makarewicz; Jacek Fijuth

Vol 1, No 1 (2002): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-05-07

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Radiation therapy for palliation of bone metastases

Roman Makarewicz, Jacek Fijuth

Advances in Palliative Medicine 2002;1(1):23-28.

Vol 1, No 1 (2002): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-05-07

Abstract

Patients with painful bone metastases comprise the largest group of patients receiving palliative radiation therapy. Effective administration of radiotherapy in these patients is based on three goals: to achieve relief of pain, to use treatment that reconciles patient inconvenience and to administer therapy with minimal toxic effects. Recent data from randomized trials demonstrated that single dose of 8 Gy in the setting of painful bone metastases may provide pain control comparable to more protracted treatment with using higher dose of radiation. Local-field irradiation with using single fraction of 8–10 Gy yields a pain relief rate of 75–90%, but patients frequently need retreatment for newly lesions or for recuring symptoms at the same site. The rate of retreatment is lower when protracted radiotherapy is used. Pain due to multiple bone metastases can be managed with single doses of half body irradiation or radionuclide therapy. These modalities can be used as a primary palliative therapy or as an adjuvant to local-field irradiation.