Pain relief and quality of life following radiotherapy for bone metastases: a randomised trial of two fractionation schedules.
BACKGROUND
The optimum dose and fractionation schedule for the palliative irradiation of painful bone metastases is controversial.


OBJECTIVE
To compare the efficacy, side-effects and effect on quality of life of two commonly used radiotherapy schedules in the management of painful bone metastases.


METHODS
In a prospective trial, 280 patients were randomised to receive either a single 10 Gy treatment or a course of 22.5 Gy in five daily fractions for the relief of localised metastatic bone pain.


RESULTS
Response rates have been calculated from 240 assessable treated sites of pain. The overall response rates were 83.7% (single treatment) and 89.2% (five fractions). The complete response rates were 38.8% (single treatment) and 42.3% (five fractions). The median duration of pain control was 13.5 weeks (single treatment) and 14.0 weeks (five fractions). None of these differences was statistically significant. There were no differences between the groups in the effect of treatment on a variety of quality of life parameters.


CONCLUSIONS
It is concluded that a single 10 Gy treatment is as effective as a course of 22.5 Gy in five fractions in the management of painful bone metastases.
Gaze
M N
MN
Department of Clinical Oncology, Western General Hospital, Edinburgh, UK.
Kelly
C G
CG
Kerr
G R
GR
Cull
A
A
Cowie
V J
VJ
Gregor
A
A
Howard
G C
GC
Rodger
A
A
D001859:Bone Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011829:Radiation Dosage; D011882:Radiotherapy, High-Energy; D016896:Treatment Outcome