effectiveness of a second course of radiation therapy treatment of recurrent or persistent pain in bone metastases

ABSTRACT

Twenty-eight patients with recurrent or persistent bone pain after previous radiation therapy for metastatic bone lesions from different primary tumors were retreated by radiation therapy. Patients had received initial palliative radiation course of 30 Gy divided into 10 fractions over two weeks. This study aimed to evaluate the clinical feasibility of retreatment of painful bone metastases. All patients received single radiation dose of 4 Gy. For purpose of data analysis, patients were classified into two groups The first group included patients with persistent and recurrent pain within three months, while the second group included patients with recurrent pain after three months. Response to retreatment was correlated to pathology of primary tumor, site of bone metastases, number of bone metastases, initial response and time to pain recurrence. The results indicated that patients who achieved initial complete response with recurrent bone pain after nine months and with limited number of bone metastases are more likely to respond to re-irradiation. On the other hand, patients with recurrent bone pain within three months are less likely to benefit from a second course of radiation therapy. Response to re- irradiation was greater in patients with breast carcinoma and with metastases in long bones