PALLIATIVE RADIOTHERAPY IN THE PATENTS WITH BONE METASTASES: A RANDOMIZED STUDY OF DIFFERENT SCHEDULES OF FRACTIONATION AND DOSES OF RADIOTHERAPY

In this study the results from a prospective trial, comparing the effects of different schedules of radiotherapy to the patients with bone metastases who were given therapy between March 1994-June 1995 are presented, 109 fields of radiotherapy were used for 87 patients. 36 of the patients were randomized to receive 1 x 8 Gy, 38 of them to receive 5 x 4 Gy and 35 of them to receive 10 x 3 Gy. Patients ages were between 15 and 81 and 51.7% of them were women, 48.3% were men. The bone metastases localized in the vertebra (47.7%), in the pelvis (24.8%), femur (14.7%), humerus (9.2%), cranium(0.9%), scapula(0.9%), mandibula(0.9%) and costa(0.9%). The effect of treatment was evaluated by pain relief, radiological response and the degree of side effects. The pain reduction (palliation) rate of 50% was achieved in 74.8% of the patients. The 10 x 3 Gy RT arm was found to be more effective than the others to achieve the response rate of 80% (P=0.008). The effect of therapy by means of radiological response was "incomplete 57.5% and stabile in 37.5% of the patients. Although wide treatment fields were used , any serious side effects were found. We concluded that 10 x 3 Gy regimen is effective in the patients whose life expectancy were longer and the performance status were better. For the other immobilized patients the palliation rate of 70% achieved with the 1 x 8 Gy and 5 x 4 Gy regimes was found to be acceptable and more convenient to the patient and less cost to society.