Radiation therapy for painful bone metastases
Bone metastases cause pain and impair quality of life, and they can lead to serious complications that require immediate treatment. Urgent surgical treatment followed by postoperative radiotherapy should be considered in bone metastases with an impending or existing pathologic fracture or spinal co...
| Main Authors: | , , |
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| Format: | Article |
| Language: | Slovenian |
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Institute of Oncology Ljubljana
2023-12-01
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| Series: | Onkologija |
| Subjects: | |
| Online Access: | https://www.revijaonkologija.si/Onkologija/article/view/528 |
| _version_ | 1827584849177739264 |
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| author | Eva Pribožič Ivica Ratoša Jasna But-Hadžić |
| author_facet | Eva Pribožič Ivica Ratoša Jasna But-Hadžić |
| author_sort | Eva Pribožič |
| collection | DOAJ |
| description |
Bone metastases cause pain and impair quality of life, and they can lead to serious complications that require immediate treatment. Urgent surgical treatment followed by postoperative radiotherapy should be considered in bone metastases with an impending or existing pathologic fracture or spinal cord compression. Patients who are unable or unwilling to undergo surgery should be referred for urgent radiotherapy. Patients with painful bone metastases without an impending or existing pathologic fracture and no spinal cord compression, regardless of the size of the metastatic lesion, are treated pharmacologically first, complemented by palliative irradiation. In palliative radiation, low total doses are prescribed and delivered in a single fraction or in short fractionation regimens. Patients with insufficient pain relief or pain relapse after initial radiation can be safely reirradiated. We conducted a retrospective review of palliative bone irradiations between 2018 – 2021 at the Institute of Oncology Ljubjana. Annually, we treat 800 bone metastases and we are seeing a decline in the number of irradiations. The most common fractionation is 5 x 4 Gy, with only 10% of patients receiving single-dose treatment. Palliative irradiation for painful bone metastases is effective, inexpensive, and safe. It is critical to select patients who will benefit from radiation therapy and present them in a multidisciplinary team meeting. Radiation treatment can be made easier to use by simplifying the procedure for the patient and prescribing the dose in one fraction.
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| first_indexed | 2024-03-08T23:37:13Z |
| format | Article |
| id | doaj.art-db9d174d688d4121abfc45a735630bc4 |
| institution | Directory Open Access Journal |
| issn | 1408-1741 1581-3215 |
| language | Slovenian |
| last_indexed | 2024-03-08T23:37:13Z |
| publishDate | 2023-12-01 |
| publisher | Institute of Oncology Ljubljana |
| record_format | Article |
| series | Onkologija |
| spelling | doaj.art-db9d174d688d4121abfc45a735630bc42023-12-14T06:18:44ZslvInstitute of Oncology LjubljanaOnkologija1408-17411581-32152023-12-0127210.25670/oi2023-008onRadiation therapy for painful bone metastases Eva Pribožič0 Ivica Ratoša1Jasna But-Hadžić2Univerzitetni klinični center MariborOnkološki inštitut Ljubljana; Univerza v Ljubljani, Medicinska fakultetaOnkološki inštitut Ljubljana; Univerza v Ljubljani, Medicinska fakulteta Bone metastases cause pain and impair quality of life, and they can lead to serious complications that require immediate treatment. Urgent surgical treatment followed by postoperative radiotherapy should be considered in bone metastases with an impending or existing pathologic fracture or spinal cord compression. Patients who are unable or unwilling to undergo surgery should be referred for urgent radiotherapy. Patients with painful bone metastases without an impending or existing pathologic fracture and no spinal cord compression, regardless of the size of the metastatic lesion, are treated pharmacologically first, complemented by palliative irradiation. In palliative radiation, low total doses are prescribed and delivered in a single fraction or in short fractionation regimens. Patients with insufficient pain relief or pain relapse after initial radiation can be safely reirradiated. We conducted a retrospective review of palliative bone irradiations between 2018 – 2021 at the Institute of Oncology Ljubjana. Annually, we treat 800 bone metastases and we are seeing a decline in the number of irradiations. The most common fractionation is 5 x 4 Gy, with only 10% of patients receiving single-dose treatment. Palliative irradiation for painful bone metastases is effective, inexpensive, and safe. It is critical to select patients who will benefit from radiation therapy and present them in a multidisciplinary team meeting. Radiation treatment can be made easier to use by simplifying the procedure for the patient and prescribing the dose in one fraction. https://www.revijaonkologija.si/Onkologija/article/view/528bone metastasespainpalliative radiotherapyfractionationpathologic fracturemalignant spinal cord compression |
| spellingShingle | Eva Pribožič Ivica Ratoša Jasna But-Hadžić Radiation therapy for painful bone metastases Onkologija bone metastases pain palliative radiotherapy fractionation pathologic fracture malignant spinal cord compression |
| title | Radiation therapy for painful bone metastases |
| title_full | Radiation therapy for painful bone metastases |
| title_fullStr | Radiation therapy for painful bone metastases |
| title_full_unstemmed | Radiation therapy for painful bone metastases |
| title_short | Radiation therapy for painful bone metastases |
| title_sort | radiation therapy for painful bone metastases |
| topic | bone metastases pain palliative radiotherapy fractionation pathologic fracture malignant spinal cord compression |
| url | https://www.revijaonkologija.si/Onkologija/article/view/528 |
| work_keys_str_mv | AT evapribozic radiationtherapyforpainfulbonemetastases AT ivicaratosa radiationtherapyforpainfulbonemetastases AT jasnabuthadzic radiationtherapyforpainfulbonemetastases |