Opioid analgesics offer a fast and very effective method of pain control. However, opioids can produce severe side effects, including constipation and somnolence. Radiation therapy used in conjunction with, or as an alternative to, opioids can readily decrease cancer pain with fewer side effects. The optimal method with which to administer palliative radiotherapy is controversial. A protracted course, lasting several weeks, may give long lasting pain relief, but burdens the patient with daily trips to a radiotherapy center.
Small trials suggest shorter courses with larger fractions offer similar pain relief.
In order to evaluate the relative efficacy of different methods of palliative radiotherapy as well as to identify variables that may influence pain response to radiation, physicians from Italy performed a prospective analysis on patients receiving radiotherapy for bone metastases from various primary sites. Materials and Methods 205 patients with 255 bone metastases were treated with radiotherapy at the Radiation Therapy Center in Latina, Italy. The spine was involved by metastases in half the patients. Patients were treated with anterior and posterior fields, from using a linear accelerator producing 6MV photons. The course of radiotherapy was determined by the treating physician and based upon several factors including the patient s life expectancy, field size and tumor location.