Radiotherapy for painful bone metastases: a systematic review.

University of Oxford, Churchill Hospital, UK.
Clinical Oncology (Impact Factor: 2.83). 02/1997; 9(3):150-4. DOI: 10.1016/S0936-6555(97)80070-2
Source: PubMed
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    ABSTRACT: La radiothérapie antalgique des métastases osseuses de première intention est un traitement efficace quel que soit le fractionnement (traitement mono- ou plurifractionné). La radiothérapie peut également être proposée en cas d’échec ou d’efficacité insuffisante d’une première irradiation (après avoir éliminé une fracture) ou l’apparition de nouveaux sites douloureux. Les autres indications sont les compressions médullaires en adjuvant à la chirurgie ou de façon exclusive et les irradiations après chirurgie pour métastase des os longs. Le développement de la radiothérapie de haute précision (en conditions stéréotaxiques) augmente les possibilités de réirradiation lorsque les doses maximales admissibles par les tissus sains ont été atteintes. Elle cherche à améliorer le contrôle local, voire la survie, chez les patients oligométastatiques. Abstract First-line palliative radiotherapy for painful bone metastases is an effective treatment whatever its fractionation (single or multiple fractions). It is also advisable after failure or insufficient effect of a first irradiation, or the appearance of new painful site. Other indications are spinal cord compression, either as an adjuvant to surgery or as sole treatment, and after surgery for long-bone metastases. The development of high-precision techniques (stereotactic conditions) enlarges the possibility of re-irradiation while tolerance doses to normal tissues have already been delivered. Local control and possibly overall survival could be improved in oligometastatic patients.
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