Fewer radiation treatments for bone metastases in patients with stage IV or incurable cancer can improve patient care while reducing the length of hospital stay, according to a study presented at the Palliative Care in Oncology Symposium (October 9–10, Boston, MA).
Senior author Kavita Dharmarajan, MD, MSc (Icahn School of Medicine, Mount Sinai Medical Center, New York, NY) explained that the standard treatment for bone metastases is 10 radiation treatments, but that randomized trials have shown that single-fraction radiation is equivalent to 10 fractions for the control of pain associated with bone metastases.
The presenters compared patterns of care and outcomes of 336 patients with stage IV or incurable cancer and symptomatic bone metastases. Participants were treated either with the standard radiation oncology care or by palliative radiation oncology service established at Mount Sinai Medical Center, which involved multidisciplinary collaboration between the radiation oncology, palliative medicine, and primary oncology teams.
The latter group of patients was significantly more likely to receive single-fraction radiation therapy or radiation therapy in two to five fractions than patients receiving standard care. Patients treated by the palliative radiation oncology service also had much shorter median hospital stays than patients receiving standard care (12 days versus 18 days). Other benefits of the palliative care service included higher rates of completing the prescribed course of therapy, achieving pain relief, and receiving palliative care after radiation treatment.
According to Dharmarajan, shorter treatment courses are currently underutilized by radiation oncologists. The findings of the presented study indicate that greater adherence to evidence-based guidelines for treatment can lead to improved outcomes for patients.
