title: 'Who', 'when' and 'how' in re-irradiation of recurrent painful bone metastases.
abstract: Re-irradiation of painful bony metastases is increasingly performed since patients are receiving better systemic treatments and having longer life expectancy, and may also be due to the increase use of initial single fraction radiotherapy. However, randomized control trial on the efficacy of re-irradiation is lacking. A recent meta-analysis concluded with a 58% response rate for pain relief by re-irradiation of symptomatic bone metastases. In this review, the effectiveness of re-irradiation in terms of clinical and economical aspects, and clinical questions on who, when, and how to re-irradiate would be discussed. A brief review of other treatment options and comparison with re-irradiation of bone metastases would be performed.
authors.affiliation: Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
authors.forename: Florence
authors.initials: F
authors.lastname: Mok
authors.affiliation: Queen Elizabeth Hospital, Hong Kong SAR, China.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Li
authors.affiliation: Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Yeung
authors.affiliation: Queen Elizabeth Hospital, Hong Kong SAR, China.
authors.forename: Kam-Hung
authors.initials: KH
authors.lastname: Wong
authors.affiliation: Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Brian
authors.initials: B
authors.lastname: Yu
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Wong
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gillian
authors.initials: G
authors.lastname: Bedard
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
keywords: Bone metastasis; Cancer; Outcome; Re-irradiation