Rapid palliative radiotherapy unit: multidisciplinary management of bone metastases.

PURPOSE: The aim of this study was to highlight the advantages of rapid access to a palliative radiotherapy unit adopting a multidisciplinary approach to symptom management to relieve pain and improve quality of life in patients with bone metastases.

MATERIALS AND METHODS: From January 2007 to December 2008, 142 oncological patients were treated with linear accelerator radiotherapy (RT) administered in a single 8-Gy fraction. The European Organization for Research and Treatment Quality of Life Questionnaire (EORTC QLQ-C30) was administered to each patient at admission and at subsequent intervals. A traditional simulator was used to define the correct patient setup, and all treatment plans were performed with a two-dimensional technique..

RESULTS: Ninety-six patients agreed to fill in the EORTC QLQ-C30 questionnaire; 80 actually completed it. Twelve weeks after RT, a reduction in pain level compared with baseline (T0) was recorded, which was classified as 1 in 36 patients (45%) and 2 in 44 patients (55%). Pain interference with daily activities was also recorded, with significantly reduced scores with respect to T0: 1 in eight patients (10%), 2 in 28 patients (35%) and 3 in 44 patients (55%); quality of life scores also improved with respect to T0: 2 in 28 patients (35%), 3 in 23 patients (29%), 4 in 22 patients (27%) and 5 in seven patients (9%).

CONCLUSIONS: The proposal for treating patients with painful bone metastases with a single 8-Gy fraction of RT, with all the procedures being performed on the same day, offers many advantages in terms of pain relief, quality of life and clinical management.