Efficacy and time course of palliative radiotherapy for pain relief in 70 patients with bone metastases ⁎

Abstract

Abstract Objective The aim of this study was to evaluate the efficacy and time course of radiotherapy for pain relief in patients with bone metastases. Methods A total of 70 patients with painful bone metastases were investigated between January 2013 and August 2015. The patients were divided into 3 groups and each group was treated with radiotherapy using 30 Gy in 10 fractions, 20 Gy in 5 fractions, or a single dose of 8 Gy. The pain over the irradiated site was assessed using a numerical rating scale (NRS) ranging from 0 to 10. Pain relief was assessed every 5 days based on a pain questionnaire. Results Complete pain relief was achieved in 14.3% (10/70) patients; partial pain relief in 74.3% (52/70); and no response in 11.4% (8/70). The overall response rate was 88.6%. No significant difference was observed between single fraction radiotherapy and multifraction radiotherapy. There was no relationship between the pain relief and treated sites. The pain score gradually decreased and most patients reached a moderate pain score (NRS < 7) on day 10-15. Conclusion Local radiotherapy is a very rapid and effective palliative treatment for painful bone metastases; however, the optimal dose and fractionation regimen remain debatable. Individualized therapy for painful bone metastases should be considered according to the patient’s condition and life expectancy.