Palliative Reirradiation for Painful Bone Metastases: Clinical Cases and Literature Review

Abstract

Summary:Reirradiation to previously irradiated peripheral bone metastases for pain has been shown to be safe and effective, but no specific trial has been completed to define the indications for reirradiation of patients with recurrent symptoms of metastatic bone disease. Thus, we aimed to assess the effectiveness and prognostic factors of reirradiation for painful bone metastases. To do so, we reviewed the cases of 14 patients with painful bone metastases who had undergone reirradiation at our hospital. A favorable pain response after reirradiation was achieved in 50% (7/14) of the patients. An interval from initial radiotherapy > 6 months was a significant prognostic factor for pain response (p = 0.03). Performance status was correlated with pain response, with borderline significance (p = 0.06). No severe adverse events were reported. We conclude that reirradiation of painful bone metastases is effective in providing pain relief, especially for patients with a long interval from initial radiation and good performance status.

Palliative Radiotherapy for Bleeding from Unresectable Gastric Cancer Using Three-Dimensional Conformal Technique

“…Although 30 Gy in 10 fractions is one of the most commonly used regimens for palliative RT for bleeding from GC, the optimal dose using such developed equipment has not yet been investigated. Furthermore, the efficacy and safety of reirradiation in some kinds of cancer have been evaluated [ 22 , 23 , 24 ]; however, reirradiation in GC has not been fully discussed, although the efficacy and safety of reirradiation using low-dose RT has been reported [ 8 , 12 ]. In the present study, we evaluated the usefulness of palliative RT including reirradiation for bleeding from unresectable GC using recent RT technology.…”