The role of radiotherapy (RT) for the management of painful bone metastases

Abstract

Radiotherapy (RT) is an established mode of treatment for metastatic bone metastases for decades and has shown to be both effective and safe. It achieves a significant pain relief, with large metaanalyses showing equal effectiveness between single fraction (SF) and multifraction (MF) RT. Overall pain response rates reach 59% and complete pain response rates 32%. The rates of reirradiation after SF RT are significantly higher than after MF RT. Re-irradiation of recurrent pain is effective and well tolerated, resulting in similar response rates as the primary irradiation of a metastatic site. Moreover no difference has been reported in the rates of pathologic fractures after SF or MF RT. Finally yet importantly, in the event of a pathological fracture, RT is preferably administered after surgical stabilization, whereas after cord compression either SF or MF RT should be carried out as soon as possible in the event that patients are not candidates for surgery. © Nova Science Publishers, Inc.