INTRODUCTION: The presence of bone @entity3 is a common event in the natural history of nearly all @entity5 which often affects the @entity1 's quality of life greatly. Bone @entity3 may cause @entity158 and pathologic fractures, or even a @entity1745 with @entity16 . We tried to assess the optimal irradiation schedule for these @entity1 and to discuss the use of radiopharmaceuticals. MATERIALS AND METHODS: We reviewed the literature focusing on studies investigating the efficacy of hypofractionated radiotherapy for bone @entity3 . We also addressed the problem of treating @entity75 with half-body irradiation and radionuclides. RESULTS: External beam irradiation achieves @entity158 palliation in more than 75% of @entity1 with bone @entity3 , even with hypofractionation down to a single-dose administration. The results of exclusive radiotherapy in the @entity1745 depend on a prompt diagnosis, @entity1 presentation and the intrinsic radiosensitivity of @entity5 cells. Palsy can always be avoided in these @entity1 . Half-body irradiation can achieve complete @entity158 relief in over 20% of @entity1 and decrease @entity158 markedly in the remaining cases with only a single-dose fraction (6-10 Gy), within 48 hours of irradiation and with little side-effects. Better results in terms of @entity158 relief (80% complete responses) and duration of palliation come from fractionated half-body irradiation (up to 17.5 Gy in 7 fractions), which however has a more delayed response (1-2 weeks) and higher @entity137 . The use of radiopharmaceuticals has been recently reevaluated after the introduction of new nuclides: results are similar to those of external beam irradiation (up to 80% responses), but cost and hematologic @entity137 are both high. Radiopharmaceuticals can be used within an integrated treatment with external beam irradiation, chemotherapy and biphosphonates. DISCUSSION: The efficacy of external beam irradiation in the palliation of bone @entity3 -related symptoms is confirmed by this literature review, even with short treatments and single-dose administrations. This is important for both @entity1 expectations and the necessity for improved resource allocation with reference to the territorial distribution and waiting lists of radiotherapy centers. Finally, as for the role of radiopharmaceuticals, the best nuclides are not widely used yet for the high cost of the treatment, even though they provide similar results to external beam irradiation. The issue of their efficacy in combination with antiblastic drugs and/or external beam irradiation remains open and will be clarified only with further randomized clinical trials.

[Role of palliative and symptomatic radiotherapy in bone XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'neoplasms'] @entity75 :: ('MESH:D001927', 'Disease') :: ['multiple skeletal lesions'] @entity16 :: ('MESH:D009422', 'Disease') :: ['severe neurologic symptoms'] @entity1745 :: ('MESH:D013117', 'Disease') :: ['cord compression syndrome'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis', 'metastases']
@entity3 :: (MESH:D009362,Disease) :: ['metastasis']
