title: Fractionated wide-field radiation therapy followed by fractionated local-field irradiation for treating widespread painful bone metastasis.
abstract: OBJECTIVE
  Wide-field radiation therapy (WFRT) is an effective treatment for widespread bone metastasis. We evaluated local-field irradiation (LFI) after fractionated WFRT (f-WFRT) for treating the patients with multiple painful bone lesions.
  
  
  METHODS
  From 1998 to 2007, 32 patients with multiple bone metastases were treated with fractionated LFI (f-LFI) after f-WFRT. All patients initially received 15 Gy in 5 fractions to a wide field, followed by LFI (9-15 Gy in 3 Gy fractions). Response was assessed by evaluating the degree of pain relief using a visual analog scale before radiotherapy, after f-WFRT, and after f-LFI.
  
  
  RESULTS
  Fractionated LFI following f-WFRT yielded an overall relief rate of 93.8% and a complete relief rate of 43.8%. The rate of the appearance of new disease was 6.3% for the patients with complete relief, 20.5% for the patients with a partial relief, and 50% for the patients with no relief.
  
  
  CONCLUSIONS
  Fractionated LFI after f-WFRT is a well-tolerated and effective treatment for multiple metastatic bone disease.
authors.affiliation: Department of Radiation Oncology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Yongkan
authors.initials: Y
authors.lastname: Ki
authors.forename: Wontaek
authors.initials: W
authors.lastname: Kim
authors.forename: Jiho
authors.initials: J
authors.lastname: Nam
authors.forename: Donghyun
authors.initials: D
authors.lastname: Kim
authors.forename: Hosang
authors.initials: H
authors.lastname: Jeon
authors.forename: Dahl
authors.initials: D
authors.lastname: Park
authors.forename: Dongwon
authors.initials: D
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000532:radiotherapy*; D010147:Pain Measurement; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome