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ASTRO publishes palliative radiotherapy for bone metastases guideline
Date:2/17/2011

The American Society for Radiation Oncology (ASTRO) Clinical Affairs and Quality Committee has developed a guideline for the use of radiation therapy in treating bone metastases. The guideline will be published in the International Journal of Radiation OncologyBiologyPhysics, an official journal of ASTRO.

Bone metastases are caused when a malignant tumor spreads to the bone. They can lead to debilitating effects including pain, fractures and paralysis due to spinal cord compression. The care of these patients requires collaboration between several types of cancer treatment specialists.

External beam radiation therapy (EBRT) provides successful pain relief in 50 to 80 percent of patients with little risk of side effects. However, the widespread variation in practice patterns between radiation oncologists presented an opportunity to standardize care through the construction of a formal treatment guideline.

Some of the committee's findings include:

  1. EBRT continues to be the mainstay for treating bone metastases.

  2. Both single doses and longer courses of radiation have shown similar pain relief outcomes, and each has advantages. A single course has proven more convenient for patients and caregivers, while longer courses have a lower incidence of repeat treatment to the same site.

  3. Repeat irradiation with EBRT might be feasible in some circumstances, though the details of its effectiveness and safety are still to be determined.

  4. Bisphosphonates do not eliminate the need for EBRT for painful metastases, and they act effectively when combined with EBRT.

  5. Stereotactic body radiation therapy can be considered for patients with a newly discovered or recurrent tumor in the spinal column or paraspinal areas; however, it is suggested that stereotactic treatment be reserved for patients who meet specific criteria, who are treated at centers with sufficient training and experience, and who are part of a
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Contact: Beth Bukata
bethb@astro.org
703-839-7332
American Society for Radiation Oncology
Source:Eurekalert

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