The use of palliative radiotherapy for bone metastasis

Background: The value of palliative radiotherapy (PRT) for bone metastases is well established, but little is known about its use in the general population.

Purpose: To describe the use of PRT for bone metastases in Ontario.

Materials and methods: This was a retrospective cohort study. Treatment records from all Ontario RT departments were linked to a population-based cancer registry to describe the use of PRT.

Results: 12.2% of the 434,241 patients, who died of cancer in Ontario between 1984 and 2004, received at least one course of PRT for bone metastases in the last 2 years of life. The rate of use of PRT varied across the province (inter-county range, 8.2-18.6%). Older patients and residents of poorer areas were less likely to receive PRT (p<0.0001). Patients diagnosed with cancer in a hospital with a radiotherapy facility and those who lived closer to a radiotherapy centre were more likely to receive PRT (p<0.0001). Over the study period, the use of PRT decreased in breast cancer and myeloma, but increased in prostate cancer (p<0.0001).

Conclusions: Access to PRT appears to be inequitable. More effort is required to make this useful treatment available to all those who would benefit from it.