ASCO: Single, high-dose RT relieves vertebral bone metastases pain

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A single, high dose of radiotherapy (RT) is as effective in relieving the pain from vertebral bone metastases as 10 smaller treatments, according to new research from the Radiation Therapy Oncology Group, which was presented Sunday at the 2009 American Society of Clinical Oncology (ASCO) meeting in Orlando, Fla.

RTOG researchers previously reported that breast and prostate cancer patients with painful bone metastases who received a single RT treatment of 8 Gy had the same pain relief and narcotic use three months after treatment as patients who received 10 RT treatments each consisting of 3 Gy for a total of 30 Gy.

They also found that patients who received the 8 Gy regimen reported in fewer side effects, although those patients did have to be retreated more often than patients who received the higher dose.

To evaluate the effectiveness of short-course RT in patients with painful vertebral bone metastases the RTOG investigators examined a 235 patient subset of the 909 patients entered on the original study, RTOG 9714. The RTOG researchers found the short course to be equally effective as the longer course (8 vs. 30 Gy) showing no statistically significant difference in pain relief (70 vs. 62 percent) or narcotic use (27 vs. 24 percent) at three months.

"It is exciting to confirm that we can provide the same amount of pain relief for patients suffering with vertebral bone metastases with only one visit to their radiation oncologist as we have been providing with 10 visits," said David D Howell, MD, lead author of the analysis from the University of Michigan School of Medicine in Ann Arbor. "With fewer side-effects and comparable pain relief, the single-dose treatment is very much appreciated, especially for patients who have already completed one or more courses of treatment for their primary disease."

RTOG, a U.S. clinical trials group funded by the National Cancer Institute, is a clinical research component of the American College of Radiology.