title: Rapid course radiation therapy vs. more standard treatment: a randomized trial for bone metastases.
abstract: OBJECTIVE
  In a prospective randomized trial we examined whether radiotherapy of painful bone metastases can be shortened using larger single doses without impairing effectivity.
  
  
  METHODS
  One hundred patients with painful bone metastases having no prior surgical intervention or treatment with x-ray therapy and had a median follow-up of 12 months were analyzed. The primary tumor was located in the breast in 43%, in the lung in 24%, and in the prostate in 14%. The most frequent sites of metastases were the pelvis (31%), the vertebral column (30%), and the ribs (20%). Further percentages of sites were: lower extremity 11%, upper extremity 6%, and skull 2%. Fifty-one patients received a short course radiotherapy with a total dose of 20 Gy in 1 week (daily dose 4 Gy), and 49 patients received 30 Gy in 3 weeks (daily dose 2 Gy).
  
  
  RESULTS
  There were no significant differences in frequency, duration of pain relief, improvement of mobility, recalcification, frequency of pathologic fractures nor survival. There was a light trend favoring 30 Gy in frequency of pain relief and recalcification. Survival was mostly influenced by primary tumor site, Karnofsky performance status, and possibly by the response to radiotherapy (pain relief).
  
  
  CONCLUSIONS
  Because of the very short life expectancy of patients with metastatic bone disease, we now use 20 Gy in 1 week as our standard to reduce hospital stay.
authors.affiliation: Department of Radiotherapy, University Hospital of Saarland, Homburg/Saar, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Niewald
authors.forename: H J
authors.initials: HJ
authors.lastname: Tkocz
authors.forename: U
authors.initials: U
authors.lastname: Abel
authors.forename: T
authors.initials: T
authors.lastname: Scheib
authors.forename: K
authors.initials: K
authors.lastname: Walter
authors.forename: C
authors.initials: C
authors.lastname: Nieder
authors.forename: K
authors.initials: K
authors.lastname: Schnabel
authors.forename: W
authors.initials: W
authors.lastname: Berberich
authors.forename: R
authors.initials: R
authors.lastname: Kubale
authors.forename: M
authors.initials: M
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies