open access

Vol 19, No 6 (2014)
Original research articles
Published online: 2014-11-01
Submitted: 2013-05-30
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Radiation therapy for the management of painful bone metastases: Results from a randomized trial

Lucia Gutiérrez Bayard, María del Salas Buzón, Esther Angulo Paín, Lourdes de Ingunza Barón
DOI: 10.1016/j.rpor.2014.04.009
·
Rep Pract Oncol Radiother 2014;19(6):405-411.

open access

Vol 19, No 6 (2014)
Original research articles
Published online: 2014-11-01
Submitted: 2013-05-30

Abstract

Aim

The aim of this study was to compare the effectiveness of two radiotherapy schedules in patients with bone metastases.

Background

We analyzed the need for re-irradiation, rates of pain control, pathological fractures, and functionality in patients randomized to single-fraction (8[[ce:hsp sp="0.25"/]]Gy 1×) or multiple-fraction radiotherapy (3[[ce:hsp sp="0.25"/]]Gy 10×) with at least 12 months follow-up, during five years. The hypothesis was that the two radiotherapy schedules are equally effective.

Materials and methods

Ninety patients with painful skeletal metastases were randomized to receive single fraction (8[[ce:hsp sp="0.25"/]]Gy) or multiple fraction (3[[ce:hsp sp="0.25"/]]Gy 10×) radiotherapy.

Results

In the single-fraction group, seven pathological fractures occurred (15.5%) versus two (4.4%) in the multiple-fraction group. There was no statistically significant difference between the time it took to suffer a pathological fracture in both groups (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.099). Patients in the single-fraction group received twelve re-irradiations (26.6%), four in the multiple-fraction group (8.8%), with no significant difference between time elapsed before the first re-irradiation (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.438).

Conclusion

This study shows no difference between the two groups for the majority of patients with painful bone metastases. Patients were followed up during five years, and the trial showed no disadvantage for 8[[ce:hsp sp="0.25"/]]Gy 1× compared to 3[[ce:hsp sp="0.25"/]]Gy 10×. Despite the fact that the pathological fracture rate is 3.75 times higher in the single-fraction group, this schedule is considered more convenient for patients and more cost-effective for radiotherapy departments.

Abstract

Aim

The aim of this study was to compare the effectiveness of two radiotherapy schedules in patients with bone metastases.

Background

We analyzed the need for re-irradiation, rates of pain control, pathological fractures, and functionality in patients randomized to single-fraction (8[[ce:hsp sp="0.25"/]]Gy 1×) or multiple-fraction radiotherapy (3[[ce:hsp sp="0.25"/]]Gy 10×) with at least 12 months follow-up, during five years. The hypothesis was that the two radiotherapy schedules are equally effective.

Materials and methods

Ninety patients with painful skeletal metastases were randomized to receive single fraction (8[[ce:hsp sp="0.25"/]]Gy) or multiple fraction (3[[ce:hsp sp="0.25"/]]Gy 10×) radiotherapy.

Results

In the single-fraction group, seven pathological fractures occurred (15.5%) versus two (4.4%) in the multiple-fraction group. There was no statistically significant difference between the time it took to suffer a pathological fracture in both groups (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.099). Patients in the single-fraction group received twelve re-irradiations (26.6%), four in the multiple-fraction group (8.8%), with no significant difference between time elapsed before the first re-irradiation (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.438).

Conclusion

This study shows no difference between the two groups for the majority of patients with painful bone metastases. Patients were followed up during five years, and the trial showed no disadvantage for 8[[ce:hsp sp="0.25"/]]Gy 1× compared to 3[[ce:hsp sp="0.25"/]]Gy 10×. Despite the fact that the pathological fracture rate is 3.75 times higher in the single-fraction group, this schedule is considered more convenient for patients and more cost-effective for radiotherapy departments.

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Keywords

Bone metastases; Palliation painful bone metastases; Radiotherapy fractionation; Palliative radiotherapy

About this article
Title

Radiation therapy for the management of painful bone metastases: Results from a randomized trial

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 19, No 6 (2014)

Pages

405-411

Published online

2014-11-01

DOI

10.1016/j.rpor.2014.04.009

Bibliographic record

Rep Pract Oncol Radiother 2014;19(6):405-411.

Keywords

Bone metastases
Palliation painful bone metastases
Radiotherapy fractionation
Palliative radiotherapy

Authors

Lucia Gutiérrez Bayard
María del Salas Buzón
Esther Angulo Paín
Lourdes de Ingunza Barón

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