International patterns of practice in radiotherapy for bone metastases: A review of the literature

Purpose: Radiation therapy is the standard treatment for symptomatic bone metastases. Several randomized control trials and meta-analyses have concluded a similar efficacy in pain relief when comparing single versus multiple fraction regimes. However, there continues to be reluctance to conform to p...

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Main Authors: Rachel McDonald, Edward Chow, Henry Lam, Leigha Rowbottom, Hany Soliman
Format: Article
Language:English
Published: Elsevier 2014-11-01
Series:Journal of Bone Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S221213741420011X
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author Rachel McDonald
Edward Chow
Henry Lam
Leigha Rowbottom
Hany Soliman
author_facet Rachel McDonald
Edward Chow
Henry Lam
Leigha Rowbottom
Hany Soliman
author_sort Rachel McDonald
collection DOAJ
description Purpose: Radiation therapy is the standard treatment for symptomatic bone metastases. Several randomized control trials and meta-analyses have concluded a similar efficacy in pain relief when comparing single versus multiple fraction regimes. However, there continues to be reluctance to conform to published guidelines that recommend a single treatment for the palliation of painful bone metastases. The purpose of this literature review is to summarize international patterns of practice, and to determine if guidelines recommending single fraction treatment have been implemented in clinical care. Methods: A literature search was conducted in Ovid Medline, Embase, and Cochrane Central. Search words included, ‘bone metastases’, ‘radiation therapy’, ‘radiotherapy’, ‘patterns of practice’, and ‘dose fractionation’. Both prospective and retrospective studies that investigated the prescription of radiotherapy to bone metastases using actual patient databases were included. Articles were excluded if they investigated hypothetical scenarios. Results: Six hundred and thirteen results were generated from the literature search. Twenty-six articles met the inclusion criteria. Of these, 11 were Canadian, 8 were European, 6 were American, and 1 was Australian. The use of single fraction radiotherapy (SFRT) ranged from 3% to 75%, but was generally lower in American studies. Choice of fractionation depended on a variety of factors, including patient age, prognosis, site of irradiation, and physician experience. Conclusion: Despite the publication of robust randomized control trials, meta-analyses, and clinical practice guidelines recommending the use of a single treatment to palliate uncomplicated bone metastasis, SFRT is internationally underutilized.
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spelling doaj.art-44d3b11fd7ea4823856b3cd1de3c76442022-12-21T18:58:54ZengElsevierJournal of Bone Oncology2212-13742014-11-01339610210.1016/j.jbo.2014.10.003International patterns of practice in radiotherapy for bone metastases: A review of the literatureRachel McDonaldEdward ChowHenry LamLeigha RowbottomHany SolimanPurpose: Radiation therapy is the standard treatment for symptomatic bone metastases. Several randomized control trials and meta-analyses have concluded a similar efficacy in pain relief when comparing single versus multiple fraction regimes. However, there continues to be reluctance to conform to published guidelines that recommend a single treatment for the palliation of painful bone metastases. The purpose of this literature review is to summarize international patterns of practice, and to determine if guidelines recommending single fraction treatment have been implemented in clinical care. Methods: A literature search was conducted in Ovid Medline, Embase, and Cochrane Central. Search words included, ‘bone metastases’, ‘radiation therapy’, ‘radiotherapy’, ‘patterns of practice’, and ‘dose fractionation’. Both prospective and retrospective studies that investigated the prescription of radiotherapy to bone metastases using actual patient databases were included. Articles were excluded if they investigated hypothetical scenarios. Results: Six hundred and thirteen results were generated from the literature search. Twenty-six articles met the inclusion criteria. Of these, 11 were Canadian, 8 were European, 6 were American, and 1 was Australian. The use of single fraction radiotherapy (SFRT) ranged from 3% to 75%, but was generally lower in American studies. Choice of fractionation depended on a variety of factors, including patient age, prognosis, site of irradiation, and physician experience. Conclusion: Despite the publication of robust randomized control trials, meta-analyses, and clinical practice guidelines recommending the use of a single treatment to palliate uncomplicated bone metastasis, SFRT is internationally underutilized.http://www.sciencedirect.com/science/article/pii/S221213741420011XBone metastasesRadiationPattern of practiceDose fractionation
spellingShingle Rachel McDonald
Edward Chow
Henry Lam
Leigha Rowbottom
Hany Soliman
International patterns of practice in radiotherapy for bone metastases: A review of the literature
Journal of Bone Oncology
Bone metastases
Radiation
Pattern of practice
Dose fractionation
title International patterns of practice in radiotherapy for bone metastases: A review of the literature
title_full International patterns of practice in radiotherapy for bone metastases: A review of the literature
title_fullStr International patterns of practice in radiotherapy for bone metastases: A review of the literature
title_full_unstemmed International patterns of practice in radiotherapy for bone metastases: A review of the literature
title_short International patterns of practice in radiotherapy for bone metastases: A review of the literature
title_sort international patterns of practice in radiotherapy for bone metastases a review of the literature
topic Bone metastases
Radiation
Pattern of practice
Dose fractionation
url http://www.sciencedirect.com/science/article/pii/S221213741420011X
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