Study of three different fractionation regimens in palliative radiotherapy for painful bone metastases

Abstract

Background: To assess the efficacy of single fraction with two different multi-fractionated radiotherapy regimens in treatment of painful bone metastases. Methods: Patients with painful bone metastases were randomly assigned to receive: Arm A: 8 Gray (Gy) in single fraction (n=15), Arm B: 20 Gy in 5 fractions at the rate of 4 Gy per fraction (n=15) and Arm C: 30 Gy in 10 fractions at the rate of 3 Gy per fraction (n=15). The arms were compared in terms of pain relief, performance improvement, analgesic requirement and duration of overall response at 1week, 1month, and 3 months after treatment. Results: Pain relief in Arms A, B and C at 1 week were 60%, 53.3% and 60%; at 1 month were 71.4%, 73.3%, 73.3%, at 3 months were 78.5%, 80% and 80% respectively. Performance improvement in Arm A, B and C at 1 week 60%, at 1 month 65%, 66% and 66%, at 3 months 78.5% ,80% and 80% respectively. Duration of overall response in all the patients who improved after therapy is 3 months There was no statistically significant difference between three arms with respect to pain relief, performance improvement, analgesic requirement and duration of overall response. Conclusions: The 8 Gy Single fraction is as efficacious as multi-fractionated regimens. Moreover, it is less expensive, decreases duration of hospital stay so single fraction can be used as an effective palliation method. Jilla S, Ratnam SV, Naidu KVJR, Monica I, Ranadheer M, Suresh P. Study of three different fractionation regimens in palliative radiotherapy for painful bone metastases. J Clin Sci Res 2014;3:90-6. DOI: http://dx.doi.org/10.15380/22775706.JCSR.13.025. Received: 28 May, 2013. Corresponding author: Dr Swapna Jilla, Assistant Professor, Department of Radiation Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India. e-mail: swapnaranadheer@gmail.com Three different fractionation regimens for bone metastates Jilla et al