Treatment of Localized Bone Pain in Bone Metastases
Localized bone pain is a common and distressing consequence of bone metastases. The primary therapeutic objective in this setting is durable pain relief, enabling patients to maintain function and quality of life.
Clinical Goal
Bone pain relief — effective, sustained reduction of pain at the site of metastatic bone involvement.
Treatment Approach (overview)
External beam radiotherapy directed at the symptomatic site is the established treatment of choice for palliation of localized bone pain, with supporting pharmacological measures also forming part of the approach.
Fractionation options, schedule selection, and full supportive-care details are in the structured protocol.
References
- Radiation therapy is the treatment of choice for palliation of localized bone pain.
- Multiple prospective randomized trials have shown pain relief equivalency for dosing schema including 30 Gy in ten fractions, 24 Gy in six fractions, 20 Gy in five fractions, and a single 8 Gy fraction for patients with previously un-irradiated painful bone metastases.
- Dexamethasone may reduce the frequency of pain flare.
- It is effective in a majority of patients, although a transient worsening of pain may occur in some cases (30–40%), typically in the first few days after RT, but this flare generally lasts 1 or 2 days.
DOI: 10.1007/s12094-016-1590-1
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