Wednesday, June 29, 2005
The Journal of the National Cancer Institute has a randomized controlled trial of short course vs long course radiotherapy for painful bony mets . A single 8 Gy therapy is compared to 30 Gy over 10 treatment fractions. Both were found to be equally efficacious with more toxicity in the 30 Gy arm but with more need for retreatment in the 8 Gy arm (18% vs 9%). This is not the first trial to conclude that they are, by some measures, equivalent; nevertheless apparently short course is not being widely adopted. It seems, however, that if short course therapy becomes commonplace it will further its use in the hospice (& not only palliative) setting as it will be cheaper, easier, and more accessible to hospice patients.