Results and costs of single dose versus fractionated palliative radiotherapy of bone metastasis

ABSTRACT

The skeleton is the most common site of metastatic disease in most solid tumors. Local field irradiation yields a pain relief rate of 80% to 90% however effectiveness alone is not a sufficient basis to initiate services in most practical health care contexts. Cost effectiveness analysis [CEA] can combine information on the health benefits, health risks, and costs of health care services. This study aimed to evaluate results and cost - effectiveness of single [8 Gy / 1 F] dose versus fractionated [30 Gy / 10 F] palliative radiotherapy of bone metastasis. The study included 86 patients randomized into 2 groups. There was no statistically significant difference between the 2 groups in pain relief after 1 week, 6 weeks and 3 months. Also; there was no relation between site of metastasis and pain relief. The 8 Gy / 1 F was more cost - effective than the 30 Gy / 10 F irradiation in palliating painful bone metastasis and we concluded that single fraction radiotherapy may be considered as the palliative treatment of choice for cancer patients with painful bone metastasis at least when long survival is not expected