Local external beam radiotherapy is the most effective treatment for the palliation of painful bone metastases [1]. 50-80% of patients achieve a significant improvement in pain at the treated site, with up to a third of patients receiving complete pain relief [2]. The Royal College of Radiology (RCR) recommends a single 8Gy fraction for the initial therapy of pain from abony metastasis [3]. Furthermore, a randomised-controlled trial found non-inferiority with a single 8Gy fraction [4]. Recent advances in technology and CT planning have enabled the...

Patients treated for painful bony metastases in our department from 1st January 2017 to 30th June 2017 were identified.Patients treated for metastatic spinal cord compression were excluded,as the guidelines differ for the treatment of this. Retrospectively,data was collectedfrom electronic records on patient demographics, including age, gender and primary tumour types;dose/fractionation; and treatment technique. Further to this, date of death, if applicable, was identified and used with the date of treatment to acquire mortality data.

Between 1st January 2017 and 30th June 2017, 70 patients underwent a total of 94 courses of palliative radiotherapy treatment. The mean age was 69.3, with a range from 46 to 97. The male to female ratio was 3:2, with 42 males and 28 females undergoing treatment. There were 14 different primary tumour types treated. Lung (27.1%) and prostate (25.7%)cancer were the most common tumour types (Figure 1). 59.6% of patients were treated with a single 8Gy fraction, 31.9% with 20Gy in 5 fractions and...

In accordancewith the Royal College of Radiology guidelines, asingle 8Gy fraction was the most commonly used treatment for painful bony metastases at the Royal Free NHS Foundation Trust. However,a significant number of patients were treated with multi-fractionation, particularly 20Gy in 5 fractions. Whilst it could be argued that radiotherapy should be delivered on an individual basis and there are many reasonsfor multi-fractionation, it should benoted thatthe high mortality of the cohort supports a single fraction to reduce the burden of treatment for patients with poor...

1.Coleman R,Body J, Aapro M,Hadji P,Herrstedt J (2014) Bone health in cancer patients: ESMO Clinical Practice Guidelines. Annals of Oncology.25(3):iii124-37. 2.Chow E,Harris K,Fan G,Tsao M, Sze W (2007)Pallliative radiotherapy trials for bone metastases: A systematic review. Journal of Clinical Oncology. 25:1423-36. 3. Royal College of Radiologists (2016) Radiotherapy dose fractionation, second edition, December 2016. [Online]. Available: https://www.rcr.ac.uk/system/files/publication/field_publication_files/bfco163_dose_fractionation_2nd_ed_march2017.pdf. [Accessed 30 March 2018]. 4. Roos D,Turner S,O'Brien P,Smith J, Spry N, Burmeister B,Hoskin P, Ball D (2005)Randomized trial of 8 Gy in 1 versus 20 Gy in...