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Update on radiation treatment for cancer pain

Chow, Edward

Current Opinion in Supportive and Palliative Care: April 2007 - Volume 1 - Issue 1 - p 11–15
doi: 10.1097/SPC.0b013e328133f5d8
Pain: cancer
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Purpose of review This review addresses the latest advances in radiation treatment for cancer pain.

Recent findings There is reluctance worldwide to adopt single fraction radiotherapy as standard practice. This is well summarized by a review article reporting on surveys on practice patterns among radiation oncologists worldwide. It was suggested by the Tasman Radiation Oncology Group trial, however, that patients with neuropathic pain may need multiple treatments. Patients with bone metastases may outlive the benefits of palliative radiation and require re-irradiation. A recent report from the Dutch Bone Metastasis Study confirmed the effectiveness of re-irradiation in both responders and nonresponders to initial radiation therapy. Effects of palliative radiotherapy on function and quality of life have been explored in various studies but with disparate conclusions. This may stem from a lack of a good, patient-based instrument with which to measure quality of life. A project by the European Organisation for Research and Treatment of Cancer Quality of Life Group is currently under way to develop a bone metastases module. Patients receiving single fraction radiotherapy may be at greater risk for pain flare.

Summary Patients with uncomplicated bone metastases can be effectively palliated with single fraction radiotherapy.

Department of Radiation Oncology, University of Toronto, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada

Correspondence to Dr Edward Chow MBBS, MSc, FRCPC, Department of Radiation Oncology, University of Toronto, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5 Tel: +1 416 480 4998; fax: +1 416 480 6002; e-mail: Edward.Chow@sunnybrook.ca

© 2007 Lippincott Williams & Wilkins, Inc.