title: Painful bone metastasis in elderly treated with radiation therapy: Single- or multiple-fraction regimen? A multicentre retrospective observational analysis.
abstract: BACKGROUND
  Bone metastases are a frequent complication of advanced oncologic disease. Pain associated to bone metastasis is a major cause of morbidity in cancer patients, especially in elderly.
  
  
  OBJECTIVE
  The aim of this multicentric retrospective observational study is to evaluate the efficacy of different schedules of radiation therapy in elderly patients in terms of pain relief.
  
  
  METHODS
  206 patients over the age of 60 were enrolled in 1 year time for a multicentre retrospective observational study. Patients were treated with palliative purposes for painful bone metastases.
  
  
  RESULTS
  Pain intensity difference (PID) was found in 72% of patients. Reported PID was statistically significant for p < 0.01. Pain intensity measured by a point numeric rating scale was statistically significant reduced for p < 0.05 by one-fraction regimen compared to other two regimens.
  
  
  CONCLUSIONS
  In recent years, numerous studies have evaluated the most appropriate regimen of fractionation in individual cases, despite this, a consensus about the best schedule is still debated.
  
  
  CONCLUSIONS
  On our analysis, single-fractionation scheme (8 Gy) confirmed to be statistical significant effective in providing pain reduction due to bone metastases. Radiation therapy provides significant pain relief of symptomatic bone metastases, but appropriate radiotherapy scheduled is needed in order to get significant response to treatment. Multidisciplinary approach is warranted to value the balance between the therapeutic objectives and the patient quality of life.
authors.affiliation: Division of Radiation Oncology, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Falivene
authors.affiliation: Second University of Naples, Piazza Miraglia, 80131, Naples, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pezzulla
authors.affiliation: Division of Radiation Oncology, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Di Franco
authors.affiliation: European Medical Imaging - Radiation Oncology, Fondazione Muto-onlus, Napoli, Italia, Via Taverna Rossa, 169, 80020, Casavatore, Naples, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Giugliano
authors.affiliation: Department of Breast Cancer, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy. emanuelaexpo@hotmail.it.|Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy. emanuelaexpo@hotmail.it.
authors.forename: E
authors.initials: E
authors.lastname: Esposito
authors.affiliation: Second University of Naples, Piazza Miraglia, 80131, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Scoglio
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Amato
authors.affiliation: Division of Radiation Oncology, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Borzillo
authors.affiliation: Department of Breast Cancer, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: D'Aiuto
authors.affiliation: Division of Radiation Oncology, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione Giovanni Pascale" - IRCCS, Via Mariano Semmola, 80131, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Muto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000532:radiotherapy; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Bone metastases; Elderly; Radiation therapy; Single-fraction regimen