Comparison of 8 Gy single fraction versus 20 Gy in five fractions or 30 Gy in 10 fractions radiotherapy for the treatment of metastatic bone pain

Abstract EN

-Objectives: The aim of this study was to compare the effectiveness of pain control of most common fractionation used in oncology to treat bone metastases which are 8Gy single fraction, 20Gy in five fractions and 30Gy in 10 fractions.

Method: A total sample of 120 patients who were known to have stage IV cancer with bone metastasis were allocated to receive either 8Gy single fraction, 20Gy in five fractions or 30Gy in 10 fractions for the treatment of their pain between January 2007 and December 2009 at King Hussein Medical Center.

Pain severity and analgesic requirements were recorded by the investigator on a questionnaire before treatment, at two weeks and at one, two, three, four, five, six, eight, 10 and 12 months after radiotherapy.

Pain relief was the primary endpoint of treatment benefit.

Results: There was no difference in the time to first improvement in pain, time to complete pain relief, or in time to first increase in pain at any time up to 12 months after randomization, nor in the class of analgesics used.

Retreatment was twice as common after 8Gy as after multifraction radiotherapy, although retreatment for residual or recurrent pain did not reflect a difference between the three groups in the probability of pain relief.

Conclusion: A single fraction of 8Gy when used for the treatment of bone metastasis is as safe and effective as a multifraction regimen for the palliation of metastatic bone pain for at least 12 months.

This may make it suitable alternative to the multifraction radiotherapy regimens.