8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-upOn behalf of the Bone Pain Trial Working Party

摘要: Abstract Aim : To compare a single fraction of 8 Gy with course multifraction radiotherapy in terms long-term benefits and short-term side effects patients painful skeletal metastases. Methods Seven hundred sixty-five metastases requiring palliative were entered into prospective randomised clinical trial comparing regimen (20 Gy/5 fractions or 30 Gy/10 fractions). Patients recorded pain severity analgesic requirements on self-assessment questionnaires before treatment, at 2 weeks 1, 2, 3, 4, 5, 6, 8, 10 12 months after radiotherapy. Pain relief was the primary endpoint treatment benefit. Short-term side-effects compared subset 133 consecutive who graded nausea, vomiting antiemetic usage prior to daily intervals from days 1 14. Results Overall survival 44%, no statistically significant difference apparent between groups. There differences time first improvement pain, complete increase any up randomisation, nor class used. Retreatment twice as common than radiotherapy, although retreatment for residual recurrent did not reflect groups probability relief. The rate is thought greater readiness prescribe fraction, need. incidence vomiting, spinal cord compression pathological fracture two Conclusions A safe effective palliation metastatic bone least months. convenience lower cost make choice majority patients.