Single versus multiple fractions of palliative radiotherapy for bone metastases: A randomized clinical trial in Iranian patients

Farnaz Amouzegar-Hashemi, Haleh Behrouzi, Ali Kazemian, Behnam Zarpak, Peiman Haddad


Aim. To compare single versus multiple fractions of radiotherapy (RT) for palliation of bone metastases in Iranian patients.
Patients and methods. Adult patients with painful multiple uncomplicated bone metastases were randomized to 8 Gray (Gy) in a single fraction or 30 Gy in 10 fractions. Patient’s pain was evaluated just before and again one month after the end of RT, and graded on a scale of 1-4. Mean reduction in pain grade and the palliative response were compared in the two groups.
Results. Fifty-eight patients (31 multiple fractions, 27 single fraction) were available for evaluation of pain one month after treatment. The reduction in grade of pain was -0.8 to 2.6 with a mean of 1.1. The mean reduction of pain was 1.4 in patients ?50 years and 0.9 in those >50 years (p=0.01). There were 8 (14%) complete responses, 33 (57%) partial responses and 17 (29%) no responses, with a response rate of 71%. The mean reduction in pain and the number of responses in the two groups were not statistically different (p>.01). Patients’ gender, primary tumor, RT site and fractionation did not have any significant effect on reduction of pain. The only factor with a significant effect was age (p=0.002).
Conclusions. There was no difference in palliative response among Iranian patients with uncomplicated bone metastases treated with a single fraction versus 10 fractions of palliative RT. Younger patients responded better.

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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)