title: Management of painful bone metastases: our experience according to scientific evidence on palliative radiotherapy.
abstract: OBJECTIVE
  Our aim was to evaluate retrospectively the role of the radiotherapy in the multi-disciplinary management of pain due to bone metastases.
  
  
  METHODS
  A total of 305 patients received radiotherapy with or without bisphosphonate and antalgic drugs. Tolerability and efficacy were evaluated using a Numerical Rating Scale, Pain Intensity Difference evaluation scale related to administration of the drug, a 5-point verbal scale of the patients' general impression.
  
  
  RESULTS
  We found differences in some patient subgroups: pain reduction was significantly more evident in patients treated with a single-fraction radiotherapy scheme. Overall, 68% of patients experienced an improvement in pain control using concomitant drugs during radiotherapy.
  
  
  CONCLUSIONS
  Our study underlines the role of radiotherapy in the management of metastatic bone pain. The use of rapid-onset opioids to prevent predictable pain is a crucial step in managing radiotherapy. An interdisciplinary approach is recommended.
authors: Radiation Oncology, Second University of Naples, Pza Miraglia, 80131 Naples, Italy. sara.falivene@gmail.com.
authors: Rossella
authors: R
authors: Di Franco
authors: Sara
authors: S
authors: Falivene
authors: Vincenzo
authors: V
authors: Ravo
authors: Massimo
authors: M
authors: Mammucari
authors: Ennio
authors: E
authors: Sarli
authors: Stella
authors: S
authors: Baffini
authors: Giampaolo
authors: G
authors: De Palma
authors: Alfonsina
authors: A
authors: Pepe
authors: Marianna
authors: M
authors: Traettino
authors: Matteo
authors: M
authors: Muto
authors: Salvatore
authors: S
authors: Cappabianca
authors: Paolo
authors: P
authors: Muto
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000532:radiotherapy; D010147:Pain Measurement / Q000528:radiation effects*; D010166:Palliative Care; D012189:Retrospective Studies
keywords: Radiotherapy; bone metastases; fractionation; pain; rapid-onset opioids