A prospective randomised trial of 4 Gy or 8 Gy single doses in the treatment of metastatic bone pain.
270 patients with painful bone metastases requiring palliative radiotherapy were randomised to receive single fractions of 4 Gy or 8 Gy in a randomised trial. Pain scores and analgesic usage were recorded before treatment and at 2, 4, 8 and 12 weeks. Pain was assessed by patients on a 4 point graded scale using pain charts administered by a central trials office. Response was defined as an improved rating compared to the pretreatment value. Compliance with the pain chart was 72% at 4 weeks. At 4 weeks, the actual response rates were 69% for 8 Gy and 44% for 4 Gy (p less than 0.001), but there was no difference in complete response (no pain) rates at 4 weeks or duration of response between the two arms. It is concluded that 8 Gy gives a higher probability of pain relief than 4 Gy, but that 4 Gy can be an effective alternative in situations of reduced tolerance.
Department of Radiotherapy & Oncology, Royal Marsden Hospital & Institute of Cancer Research, Sutton, Surrey, U.K.
P J
PJ
Hoskin
P
P
Price
D
D
Easton
J
J
Regan
D
D
Austin
S
S
Palmer
J R
JR
Yarnold
D001859:Bone Neoplasms / Q000503:physiopathology / Q000532:radiotherapy / Q000556:secondary*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D010146:Pain / Q000532:radiotherapy*; D010166:Palliative Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage