Evaluation of single dose versus fractionated palliative radiotherapy in breast cancer painful bone metastases

External beam radiotherapy is a well recognized and effective modality in palliation of symptomatic bone metastases, but the optimal dose and fractionation regimen is still debated. In this study, 60 female patients with established diagnosis of breast cancer and painful bone metastases, apart from vertebral column, and not previously irradiated were randomized into two groups. All patients were treated by radiotherapy alone to receive single dose of 8 Gy in one group and 30 Gy fractionated in 10 days in the other group. They were evaluated for pain. mobility, performance status, and analgesic consumption before treatment and weekly for two weeks alter treatment. There was no significant differences in response for either the total score [pain. mobility, performance status and analgesic consumption] or pain score in the two groups. The patients were markedly improved, nearly to the same extent in both groups. There was no advantage of the fractionated treatment as compared to the single dose in pain relief. The results showed that in the majority of patients with painful bone metastases a single fraction of 8 Gy will be as effective as protracted fractionated treatment