Management of painful bone metastases: our experience according to scientific evidence on palliative radiotherapy

Anticancer Res. 2014 Feb;34(2):1011-4.

Abstract

Aim: Our aim was to evaluate retrospectively the role of the radiotherapy in the multi-disciplinary management of pain due to bone metastases.

Patients and methods: A total of 305 patients received radiotherapy with or without bisphosphonate and antalgic drugs. Tolerability and efficacy were evaluated using a Numerical Rating Scale, Pain Intensity Difference evaluation scale related to administration of the drug, a 5-point verbal scale of the patients' general impression.

Results: We found differences in some patient subgroups: pain reduction was significantly more evident in patients treated with a single-fraction radiotherapy scheme. Overall, 68% of patients experienced an improvement in pain control using concomitant drugs during radiotherapy.

Conclusion: Our study underlines the role of radiotherapy in the management of metastatic bone pain. The use of rapid-onset opioids to prevent predictable pain is a crucial step in managing radiotherapy. An interdisciplinary approach is recommended.

Keywords: Radiotherapy; bone metastases; fractionation; pain; rapid-onset opioids.

MeSH terms

  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / pathology
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain / radiotherapy
  • Pain Measurement / radiation effects*
  • Palliative Care
  • Retrospective Studies