Image-guided Therapy of Skeletal Metastases
Image-guided Therapy of Skeletal Metastases
External-beam radiation therapy (EBRT), with or without systemic chemotherapy or hormonal therapy, is the standard of care for the alleviation of pain caused by skeletal metastases. Prospective randomized trials comparing single- vs multiple-fraction radiotherapy regimens resulted in overall pain relief in 53% to 86% of patients with uncomplicated bone metastases. Complete response varied from 15% to 58%. A higher response rate was seen for patients with breast cancer and prostate cancer than for those with lung cancer. A higher incidence of re-treatment occurred with the single-fraction treatment (18% to 35%) than with a 10-fraction treatment (8% to 9%). Although re-treatment of nonresponders and those with disease progression can be successful, patients may not be able to receive recurrent treatment because of toxicity or limited tolerance of normal tissue for additional radiation.
External-beam Radiation Therapy
External-beam radiation therapy (EBRT), with or without systemic chemotherapy or hormonal therapy, is the standard of care for the alleviation of pain caused by skeletal metastases. Prospective randomized trials comparing single- vs multiple-fraction radiotherapy regimens resulted in overall pain relief in 53% to 86% of patients with uncomplicated bone metastases. Complete response varied from 15% to 58%. A higher response rate was seen for patients with breast cancer and prostate cancer than for those with lung cancer. A higher incidence of re-treatment occurred with the single-fraction treatment (18% to 35%) than with a 10-fraction treatment (8% to 9%). Although re-treatment of nonresponders and those with disease progression can be successful, patients may not be able to receive recurrent treatment because of toxicity or limited tolerance of normal tissue for additional radiation.
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