Kapoor, A., Singhal, M.K., Bagri, P.K., Nirban, R.K., Maharia, S., Narayan, S., & Kumar, H.S. (2015). Comparison of single versus multiple fractions for palliative treatment of painful bone metastasis: First study from north west India. Indian Journal of Palliative Care, 21, 45–48.
DOI Link
Study Purpose
To compare pain outcomes with two different radiotherapy dosing schedules for pain associated with bone metastases
Intervention Characteristics/Basic Study Process
Referred patients were allocated to two different dosage groups based on the discretion of the radiation oncologist. Pain was assessed at the end of treatment and on days 8, 15, and 30 in follow-up.
Sample Characteristics
- N = 187
- MALES: 64%, FEMALES: 36%
- KEY DISEASE CHARACTERISTICS: Breast, lung, prostate, renal, and thyroid cancers; 71% had metastases only on vertebrae
Setting
- SITE: Single site
- SETTING TYPE: Outpatient
- LOCATION: India
Phase of Care and Clinical Applications
Study Design
Prospective study
Measurement Instruments/Methods
- Visual Analog Scale (VAS)
Results
In total, 62% of patients received a single fraction of 8 Gy and the rest had 10 fractions of 3 Gy. There were no significant differences between these groups in overall pain reduction.
Conclusions
Single and multiple fraction radiation therapy schedules provided similar results for the control of pain from bone metastases.
Limitations
- Risk of bias (no blinding)
- Risk of bias (no random assignment)
- Subject withdrawals ≥ 10%
- Other limitations/explanation: No information on analgesic or bone modifying agent use was provided. There was no intent to treat analysis for patients lost to follow-up. No sample demographics were provided.
Nursing Implications
Single fraction radiotherapy for pain control appeared to be as effective as multiple fraction dosing. Single fraction dosing may provide a more practical and convenient alternative for pain control. There could be differences in adverse effects, which were not discussed in this report.