Randomized clinical trial with two palliative radiotherapy regimens in painful bone metastases: 30 Gy in 10 fractions compared with 8 Gy in single fraction

Radiother Oncol. 2008 Nov;89(2):150-5. doi: 10.1016/j.radonc.2008.05.018. Epub 2008 Jun 13.

Abstract

Background and purpose: The aim was to demonstrate similar pain relief with two schedules of radiotherapy for painful bone metastases.

Materials and methods: A total of 160 patients were assigned to receive a single 8-Gy fraction or 30 Gy in 10 fractions. Pain intensity was measured on an ordinal pain scale of 0-10. Partial response was defined as a pain reduction of two points or more and complete response as a pain score of zero at the treated area. Response follow-up was at 3, 12, 24 and 48 weeks.

Results: The overall response was 75% in the 8-Gy arm and 86% in the 30-Gy arm. Complete response and partial response rates were 15% and 60% in the 8-Gy arm, 13% and 73% in the 30-Gy arm. Acute toxicity was of 18% in the 30-Gy arm and of 12% in the 8-Gy arm. These differences were not statistically significant. The re-treatment rate was 28% vs 2% in the 8-Gy and 30-Gy arms, respectively, these were statistically significant.

Conclusions: A single-fraction regimen of 8 Gy was as safe and effective as a multifraction regimen of 30 Gy for painful bone metastases in terms of pain relief.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary*
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Palliative Care / methods*
  • Radiotherapy Dosage
  • Statistics, Nonparametric
  • Treatment Outcome