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Topics:
Radiation Oncology • Palliation
Would you offer 12-16 Gy in a single fraction for a symptomatic, non-vertebral bone metastasis?
Treating to 12 to 16 Gy in 1 fraction, I based on the new ASTRO Clinical practice guideline, PRO April 2024
Answer from: Radiation Oncologist at Community Practice
Yes.We have randomized, prospective studies indicating that dose-escalation with 1-2 fractions improves control of pain over conventional RT doses - here and here. We also have a meta-analysis showing higher chance of complete response of pain with SBRT. In addition, the Canadian investigators showe...
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Answer from: Radiation Oncologist at Academic Institution
Yes, provided that the patient has a reasonable prognosis and the pain is manageable and they can wait a few extra days for planning. The 12 Gy group didn't do any better than conventional so I try to do 16 Gy even for larger mets and SIB the GTV to 18 Gy. Usually not a problem meeting OAR constrain...