Randomized clinical trial with two palliative radiotherapy regimens in painful bone metastases: 30 Gy in 10 fractions compared with 8 Gy in single fraction.
OBJECTIVE
The aim was to demonstrate similar pain relief with two schedules of radiotherapy for painful bone metastases.


METHODS
A total of 160 patients were assigned to receive a single 8-Gy fraction or 30 Gy in 10 fractions. Pain intensity was measured on an ordinal pain scale of 0-10. Partial response was defined as a pain reduction of two points or more and complete response as a pain score of zero at the treated area. Response follow-up was at 3, 12, 24 and 48 weeks.


RESULTS
The overall response was 75% in the 8-Gy arm and 86% in the 30-Gy arm. Complete response and partial response rates were 15% and 60% in the 8-Gy arm, 13% and 73% in the 30-Gy arm. Acute toxicity was of 18% in the 30-Gy arm and of 12% in the 8-Gy arm. These differences were not statistically significant. The re-treatment rate was 28% vs 2% in the 8-Gy and 30-Gy arms, respectively, these were statistically significant.


CONCLUSIONS
A single-fraction regimen of 8 Gy was as safe and effective as a multifraction regimen of 30 Gy for painful bone metastases in terms of pain relief.
Foro Arnalot
Palmira
P
Radiation Oncology Department, Hospital de l'Esperança, Barcelona, Spain. pforo@imas.imim.es
Fontanals
Agustí Valls
AV
Galcerán
Joan Carles
JC
Lynd
Frances
F
Latiesas
Xavier Sanz
XS
de Dios
Nuria Rodríguez
NR
Castillejo
Anna Reig
AR
Bassols
Marti Lacruz
ML
Galán
Joan Lozano
JL
Conejo
Ismael Membrive
IM
López
Manuel Algara
MA
D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D011879:Radiotherapy Dosage; D018709:Statistics, Nonparametric; D016896:Treatment Outcome