Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1994 September; 87(9): 503–505.
PMCID: PMC1294760

Radiotherapy for bone pain.


Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). Thirty-one per cent of the patients were aged 70 or over. The treatment of 97 of these patients was assessed. They had a total of 280 sites treated over the course of their disease. Fifty-nine per cent of sites treated received a fractionated course of radiotherapy. Site significantly influenced fractionation. Overall response rates of 82% were achieved. Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (593K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Maher EJ, Dische S, Grosch E, Fermont D, Ashford R, Saunders M, Makepeace A, Korn M, Shah D. Who gets radiotherapy? Health Trends. 1990;22(2):78–83. [PubMed]
  • Crellin AM, Marks A, Maher EJ. Why don't British radiotherapists give single fractions of radiotherapy for bone metastases? Clin Oncol (R Coll Radiol) 1989 Nov;1(2):63–66. [PubMed]
  • Priestman TJ, Bullimore JA, Godden TP, Deutsch GP. The Royal College of Radiologists' Fractionation Survey. Clin Oncol (R Coll Radiol) 1989 Sep;1(1):39–46. [PubMed]
  • Bates T. A review of local radiotherapy in the treatment of bone metastases and cord compression. Int J Radiat Oncol Biol Phys. 1992;23(1):217–221. [PubMed]
  • Hoskin PJ. Palliation of bone metastases. Eur J Cancer. 1991;27(8):950–951. [PubMed]
  • Vargha ZO, Glicksman AS, Boland J. Single-dose radiation therapy in the palliation of metastatic disease. Radiology. 1969 Nov;93(5):1181–1184. [PubMed]
  • Jensen NH, Roesdahl K. Single-dose irradiation of bone metastases. Acta Radiol Ther Phys Biol. 1976 Aug;15(4):337–339. [PubMed]
  • Hendrickson FR, Shehata WM, Kirchner AB. Radiation therapy for osseous metastasis. Int J Radiat Oncol Biol Phys. 1976 Jan-Feb;1(3-4):275–278. [PubMed]
  • Penn CR. Single dose and fractionated palliative irradiation for osseous metastases. Clin Radiol. 1976 Jul;27(3):405–408. [PubMed]
  • Qasim MM. Single dose palliative irradiation for bony metastasis. Strahlentherapie. 1977 Aug;153(8):531–532. [PubMed]
  • Tong D, Gillick L, Hendrickson FR. The palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group. Cancer. 1982 Sep 1;50(5):893–899. [PubMed]
  • Price P, Hoskin PJ, Easton D, Austin D, Palmer SG, Yarnold JR. Prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases. Radiother Oncol. 1986 Aug;6(4):247–255. [PubMed]
  • Price P, Hoskin PJ, Easton D, Austin D, Palmer S, Yarnold JR. Low dose single fraction radiotherapy in the treatment of metastatic bone pain: a pilot study. Radiother Oncol. 1988 Aug;12(4):297–300. [PubMed]
  • Cole DJ. A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clin Oncol (R Coll Radiol) 1989 Nov;1(2):59–62. [PubMed]
  • Blitzer PH. Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis. Cancer. 1985 Apr 1;55(7):1468–1472. [PubMed]
  • Arcangeli G, Micheli A, Arcangeli G, Giannarelli D, La Pasta O, Tollis A, Vitullo A, Ghera S, Benassi M. The responsiveness of bone metastases to radiotherapy: the effect of site, histology and radiation dose on pain relief. Radiother Oncol. 1989 Feb;14(2):95–101. [PubMed]
  • Madsen EL. Painful bone metastasis: efficacy of radiotherapy assessed by the patients: a randomized trial comparing 4 Gy X 6 versus 10 Gy X 2. Int J Radiat Oncol Biol Phys. 1983 Dec;9(12):1775–1779. [PubMed]
  • Okawa T, Kita M, Goto M, Nishijima H, Miyaji N. Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases. Radiother Oncol. 1988 Oct;13(2):99–104. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press