Shorter course of radiotherapy effective for palliation of painful bone metastases
A single treatment of 8 gray (Gy--a unit of measure of absorbed radiation dose) of radiation appears to be as effective in palliating painful bone metastases as the current U.S. standard treatment course of 30 Gy delivered in 10 daily treatments, according to a new study in the June 1 issue of the Journal of the National Cancer Institute.
Patients with a variety of solid tumor cancers, including lung, breast, and prostate, can develop painful metastases in the bones of the spine, pelvis, and extremities. Although the standard treatment, radiation therapy delivered in 10 daily sessions, is effective in providing relief--50% to 80% of patients experience improvement in their pain, and 20% to 50% have complete pain relief--a shorter course of treatment would be easier for patients and their families to arrange and would also have less impact on the timing of other treatments.
To determine whether a shorter course of radiation is equivalent to the standard treatment, William F. Hartsell, M.D., of Lutheran General Cancer Center in Park Ridge, Ill., and colleagues randomly assigned nearly 900 patients with breast or prostate cancer who had one to three sites of painful bone metastases to receive either 8 Gy of radiation in one treatment session or 30 Gy of radiation in 10 daily treatment sessions.
As assessed at three months after treatment, both regimens provided equivalent pain relief, and an equivalent proportion of patients no longer required narcotic medication. There was a higher rate of re-treatment but less acute toxicity in the group that received only one course of 8 Gy radiation compared with the 30-Gy group.
"Further analysis of data from [this] trial should yield important information on quality of life, health utilities (i.e., patient preferences for specific health states or treatments), and economic end points. These data will help determine whether a single dose of 8 Gy should become the standard treatment for palliation of localized painful bone metastases," they write.
In an editorial, Lisa Kachnic, M.D., of Boston University Medical Center, and Lawrence Berk, M.D., Ph.D., of Central Ohio Radiation Oncology in Columbus, discuss other trials that have addressed the use of short-course radiation for the palliation of bone metastases. "[T]hree very large randomized trials … have all demonstrated that single-fraction radiation therapy is sufficient to achieve palliation of painful bone metastases," they write. "It remains to be seen if this approach will become standard of care in the United States. The outcome may distinguish whether radiation oncologists in the United States practice evidence-based or remuneration-based medicine."
Sarah L. Zielinski | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.
To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...
A bacterial enzyme enables reactions that open up alternatives to key industrial chemical processes
The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....
Larsen C Ice Shelf rift finally breaks through
A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...
Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision
Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...