PAIN RELIEF AND QUALITY-OF-LIFE FOLLOWING RADIOTHERAPY FOR BONE METASTASES - A RANDOMIZED TRIAL OF 2 FRACTIONATION SCHEDULES

Background: The optimum dose and fractionation schedule for the pallia tive irradiation of painful bone metastases is controversial. Purpose: To compare the efficacy, side-effects and effect on quality of life o f two commonly used radiotherapy schedules in the management of painfu l bone metastases. Materials and methods: In a prospective trial, 280 patients were randomised to receive either a single 10 Gy treatment or a course of 22.5 Gy in five daily fractions for the relief of localis ed metastatic bone pain. Results: Response rates have been calculated from 240 assessable treated sites of pain. The overall response rates were 83.7% (single treatment) and 89.2% (five fractions). The complete response rates were 38.8% (single treatment) and 42.3% (five fraction s). The median duration of pain control was 13.5 weeks (single treatme nt) and 14.0 weeks (five fractions). None of these differences was sta tistically significant. There were no differences between the groups i n the effect of treatment on a variety of quality of life parameters. Conclusions: It is concluded that a single 10 Gy treatment is as effec tive as a course of 22.5 Gy in five fractions in the management of pai nful bone metastases. (C) 1997 Elsevier Science Ireland Ltd.