Introduction. Bone is the most common site of cancer dissemination and 70% of patients with bone lesions present with pain requiring therapy. Radiotherapy plays amajor role in the treatment of painful bone metastases, but optimal dose and fractionation regime remain debatable. Material and methods. To address this issue arandomized trial comparing asingle dose of 8 Gy vs. 20 Gy in 5 fractions was performed and enrolled 115 patients with 146 metastatic lesions. Pain relief was assessed longitudinally based on apain questionnaire, in which patients were supposed to record their pain intensity using a4-point scale (none, mild, moderate, severe), as well as doses and types of analgesic drugs taken. Questionnaires were collected prior to treatment, 2, 4 and 8 weeks after treatment completion and every 4 weeks thereafter. Results. Complete pain relief was achieved in 23 patients (36%) treated with one fraction of 8 Gy and in 24 patients (39%) who received 20 Gy in 5 fractions (p=0.96). Remarkable pain relief after one fraction and 5 fractions was achieved in 21 patients (33%) and 18 patients (29%), respectively (p=0.89) and moderate pain relief in 9 patients (14%) and 10 patients (16%), respectively (p=0.94). There was also no difference between the two treatment regimes according to duration of pain relief (medians of 8 and 10 months, respectively). Conclusions. Single fraction of 8 Gy is equally effective to a fractionated schedule in the treatment of painful bone metastases, and should be recommended as standard care in the majority of patients.
|Titolo:||20 Gy in five fractions versus 8 Gy in one fraction in palliative radiotherapy of bone metastases. A multicenter randomized study|
|Parole Chiave:||Bone metastases; Palliative radiotherapy; Randomized study; Single fraction irradiation|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||2003|
|Appare nelle tipologie:||01 - Articolo su periodico|