Multidisciplinary Cancer Investigation

Mendeley  

Zotero  

Dorchin M, Bayati F, Tavakoli S. Role of Palliative RT in Patients with Bone Metastasis in Ganjavian Hospital. Multidiscip Cancer Investig 2017; 1
URL: http://mcijournal.com/article-1-168-en.html

Introduction: The management of painful bone metastases requires multidisciplinary care, external beam radiation therapy (EBRT) is effective and time efficient. Patients with bone metastases require surgical decompression, osteoclast inhibitors, radiopharmaceuticals, and kyphoplasty or vertebroplasty, though EBRT should be done for the most patients. Recent publications greatly define the appropriate use of EBRT, and create a means which treatment approaches serve as quality measures of radiotherapy departments.

Materials and Methods: 48 patients (11 males and 37 females with an average age of 38 years (27-79)) with Bone metastatic cancers especially breast and prostate cancers were selected (2012-2013). The efficacy of hypo fractionated radiotherapy and the problem of treating multiple skeletal lesions with irradiation were studied.

Results: After intervention in Ahwaz center and other radiotherapeutic centers pain was relieved in 34 pts (74%) of patients, even with EBRT down to a single-dose administration. The results of exclusive radiotherapy in the cord compression syndrome depend on a prompt diagnosis, patient presentation and the intrinsic radiosensitivity of tumor cells in three patients. Palsy can always be avoided in these patients. Irradiation can completely relieve pain in over 20% of patients and even in cases with only a single-dose fraction (6-10 Gy), within 48 hours of irradiation and with little side-effects. Better relief results (80%) and duration of palliation come from fractionated irradiation (17.5 Gy in 7 fractions or 30 Gy in 10 fractions), which however has the most delayed response (1-2 weeks) with higher toxicity.

Conclusions: The efficacy of external beam irradiation in the palliation of bone metastasis-related symptoms was confirmed even with short treatments and single-dose administrations which is important for both patient’s expectations and the resources allocation with reference to the territorial distribution and radiotherapy centers. The issue of their efficacy in combination with antiblastic drugs (Bisphosphonates drugs such as Zoledronic acid) and/or external beam irradiation (EBRT) remains open and will be clarified only with further randomized clinical trials.