title: Comparison of patient-reported outcomes with single versus multiple fraction palliative radiotherapy for bone metastasis in a population-based cohort.
abstract: Despite randomized control trials showing equivalent efficacy between single-fraction (SF) and multiple-fraction (MF) radiation therapy (RT) for bone metastases (BoM), considerable variation in fractionation exists. We compared patient-reported outcomes (PROs) following SF versus MF RT in a population-based cohort.
  
  
  
  PROs were chosen to assess patients' perception of pain, function, and symptom frustration. Total score was the sum of the 3 questions.
  
  
  
  968 patients completed pre and post-RT PROs, 35% (335) had complicated BoM. Overall, there were no differences in total score improvement (79% vs. 83%; p=0.13), nor for complicated BoM (77% vs. 84%; p=0.12), SFRT and MFRT respectively. On multivariate analysis no differences in improvement in total score were observed between SFRT and MFRT overall (OR=0.71; 95% CI 0.49-1.02; p=0.06), nor for complicated BoM (OR=0.74; 95% CI 0.39-1.39; p=0.35). In the complicated BoM subset, pain complete response (CR) (19% vs. 33%; p=0.01) and functional improvement occurred more commonly in the MFRT group (69% vs. 81%; p=0.04).
  
  
  
  Improvements in PROs for pain, function and symptom frustration were similar between SFRT and MFRT supporting the use of hypofractionated regimens. Using a simple, 3-question, telephone-based questionnaire to assess response to palliative RT is a feasible strategy to collect PROs.
authors.affiliation: BC Cancer Agency Vancouver Centre, Canada; Department of Surgery, University of British Columbia, Canada; University of Calgary and Tom Baker Cancer Centre, Canada.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Conway
authors.affiliation: Department of Science, University of Northern British Columbia, Prince George, Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Yurkowski
authors.affiliation: Department of Science, University of Northern British Columbia, Prince George, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Glazier
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Quinn
authors.initials: Q
authors.lastname: Gentles
authors.affiliation: BC Cancer Agency Vancouver Centre, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Walter
authors.affiliation: BC Cancer Agency, Abbotsford Centre, Abbotsford, Canada.
authors.forename: Gale
authors.initials: G
authors.lastname: Bowering
authors.affiliation: BC Cancer Agency, Fraser Valley Centre, Surrey, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Curtis
authors.affiliation: BC Cancer Agency, Fraser Valley Centre, Surrey, Canada.
authors.forename: Devin
authors.initials: D
authors.lastname: Schellenberg
authors.affiliation: BC Cancer Agency, Centre for the Southern Interior, Kelowna, Canada.
authors.forename: Ross
authors.initials: R
authors.lastname: Halperin
authors.affiliation: BC Cancer Agency Vancouver Centre, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lapointe
authors.affiliation: BC Cancer Agency, Vancouver Island Centre, Victoria, Canada.
authors.forename: Wayne
authors.initials: W
authors.lastname: Beckham
authors.affiliation: University of Calgary and Tom Baker Cancer Centre, Canada.
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Olivotto
authors.affiliation: Department of Surgery, University of British Columbia, Canada; BC Cancer Agency, Centre for the North, Prince George, Canada. Electronic address: rolson2@bccancer.bc.ca.
authors.forename: Robert Anton
authors.initials: RA
authors.lastname: Olson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D015331:Cohort Studies; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D000071066:Patient Reported Outcome Measures
keywords: Palliative radiotherapy; Population-based; Radiation therapy fractionation