For painful bone metastases, a single conventional fraction relieves pain quickly and suits patients with a short prognosis. Patients expected to live longer, or with oligometastatic disease, have time to benefit from more durable local control. Estimate prognosis and discuss goals before referral, and include both in the request to the radiation oncologist.
- Estimate prognosis before referring for palliative radiotherapy.
- State in the referral whether the goal is rapid relief or durable control.
- Remember that single-fraction conventional radiotherapy remains effective for short-term pain relief.
Why it matters
The right schedule depends less on the bone than on how long the patient has to benefit.
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