Evaluation of Single dose Versus Fractionated Palliative Radiotherapy in Breast Cancer Painful Bone Metastases

Background: External beam radiotherapy is a wellrecognized and effective modality in palliation of symptomatic bone metastases, but the optimal dose and fractionation regimen is still debated. Patients and methods: Sixty female patients with established diagnosis of breast cancer and painful bone metastases, apart from vertebral column, and not previously irradiated were randomized into two groups. All patients were treated by radiotherapy alone to receive single dose of 8Gy in one group and 30Gy fractionated in 10 days in the other group. They were evaluated for pain, mobility, performance statu, and analgesic consumption before treatment and weekly for two weeks after treatment. Results: There was no significant differences in response for either the total score (pain, mobility, performance status, and analgesic consumption) or pain score in the two groups. The patients were markedly improved, nearly to the same extent in both groups. Conclusion: There was no advantage of the fractionated treatment as compared to the single dose in pain relief. Our results showed that in the majority of patients with painful bone metastases a single fraction of 8Gy will be as effectiveas protracted fractionated treatment.