New ASTRO guideline underscores safety, effectiveness of pal
The American Society for Radiation Oncology (ASTRO) recently published an updated clinical guideline that underscores the safety and effectiveness of palliative radiation therapy (RT) for treating painful bone metastases. Based on recent clinical trial data, the guideline recommends optimal RT dosing schedules for pain relief, including options for re-treatment.

Radiation therapy, also known as radiotherapy, is a safe and effective option to relieve symptoms associated with bone metastases. The updated guideline maintains the four previously recommended dosing schedules for external RT to treat previously unirradiated tumors: a single 8 Gray (Gy) fraction of RT; 20 Gy administered in five fractions; 24 Gy in six fractions; or 30 Gy in 10 fractions. Research indicates that patients experience similar pain relief and toxicity rates with each of the fractionation options. Although clinical trials have cited higher retreatment rates for patients who received single-fraction RT, the convenience of this option may make it the optimal choice for patients with limited life expectancy. A recent analysis of clinical trial data published in JAMA Oncology recommended that "a single 8-Gy radiotherapy dose for bone metastases should be offered to all patients, even those with poor survival."

In addition to primary treatment, the guideline also addresses retreatment of bone metastases. It recommends that reirradiation should be considered if patients experience recurrent or persistent pain more than a month following external-beam radiation therapy (EBRT) to treat peripheral bone metastases or spine lesions. Research demonstrates moderate effectiveness for reirradiation; a 2014 systematic review and meta-analysis found an overall pain response rate of 58 percent.



http://www.news-medical.net/news/20170214/New-ASTRO-guideline-underscores-safety-effectiveness-of-palliative-radiation-therapy-for-bone-metastases.aspx
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