Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Single Fraction Compared with Multiple Fraction Re-Irradiations in Patients with Painful Bone Metastases


Mona M Sayed, Mostafa E Abdel-Wanis and Mohamed I El-Sayed

Objectives: Patients with painful bone metastasis treated with palliative radiation therapy (RTH) may require
re-irradiation. This work aims at assessing the efficacy and safety of re-irradiation for painful bone metastases using
single 8 Gy fractions versus (4 Gy × 5 fractions).
Methods: From June 2011 to December 2012, previously irradiated bone metastases were re-irradiated with
single 8 Gy fractions (group I) or, 4 Gy × 5 fractions (group II). Pain management index (PMI) was determined.
Pearson’s r correlation coefficient was calculated between negative PMI at presentation and age, ECOG
Performance Status, sex, and primary cancer site.
Results: Two months after RTH, about one fifth of patients achieved no pain, mild pain in 75.5% of the
remaining patients and no patient suffered from severe pain. There was no significant difference (p>0.05) between
groups (I and II) regarding pain relief. Negative PMI score, was reduced to from 37% at presentation to 25%, at 2
months follow up. A strong negative association between PMI and performance status (p=0.0057, 95% confidence
interval between 0.109 and 0.557) was found.
Conclusion: Palliative re-irradiation with either single 8 Gy fraction or with, 4 Gy × 5 fractions was effective
and safe in pain relief.


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