Patterns of Practice in Palliative Radiotherapy for Painful Bone Metastases: A Survey in Japan
- Department of Radiation Oncology, St. Luke's International Hospital, Tokyo (Japan)
- Department of Radiation Oncology, Saitama Medical University International Medical Center, Hidaka (Japan)
- Department of Radiation Oncology, Miyagi Cancer Center, Natori (Japan)
- Division of Radiation Oncology, Shizuoka Cancer Center, Mishima (Japan)
- Department of Radiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya (Japan)
- Department of Radiology, KKR Sapporo Medical Center, Sapporo (Japan)
- Department of Radiology, Teikyo University Mizonokuchi Hospital, Kawasaki (Japan)
- Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo (Japan)
- Department of Radiation Oncology, Shimane University Hospital, Izumo (Japan)
Purpose: To determine the current patterns of practice in Japan and to investigate factors that may make clinicians reluctant to use single-fraction radiotherapy (SF-RT). Methods and Materials: Members of the Japanese Radiation Oncology Study Group (JROSG) completed an Internet-based survey and described the radiotherapy dose fractionation they would recommend for four hypothetical cases describing patients with painful bone metastasis (BM). Case 1 described a patient with an uncomplicated painful BM in a non-weight-bearing site from non-small-cell lung cancer. Case 2 investigated whether management for a case of uncomplicated spinal BM would be different from that in Case 1. Case 3 was identical with Case 2 except for the presence of neuropathic pain. Case 4 investigated the prescription for an uncomplicated painful BM secondary to oligometastatic breast cancer. Radiation oncologists who recommended multifraction radiotherapy (MF-RT) for Case 2 were asked to explain why they considered MF-RT superior to SF-RT. Results: A total of 52 radiation oncologists from 50 institutions (36% of JROSG institutions) responded. In all four cases, the most commonly prescribed regimen was 30 Gy in 10 fractions. SF-RT was recommended by 13% of respondents for Case 1, 6% for Case 2, 0% for Case 3, and 2% for Case 4. For Case 4, 29% of respondents prescribed a high-dose MF-RT regimen (e.g., 50 Gy in 25 fractions). The following factors were most often cited as reasons for preferring MF-RT: 'time until first increase in pain' (85%), 'incidence of spinal cord compression' (50%), and 'incidence of pathologic fractures' (29%). Conclusions: Japanese radiation oncologists prefer a schedule of 30 Gy in 10 fractions and are less likely to recommend SF-RT. Most Japanese radiation oncologists regard MF-RT as superior to SF-RT, based primarily on the time until first increase in pain.
- OSTI ID:
- 22056349
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 83, Issue 1; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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