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World J Clin Oncol. Dec 10, 2014; 5(5): 845-857
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.845
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.845
Palliative radiotherapy for bone metastases from lung cancer: Evidence-based medicine?
Alysa Fairchild, Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB T6G 1Z2 Alberta, Canada
Author contributions: Fairchild A solely contributed to this paper.
Correspondence to: Alysa Fairchild, BSc, MD, FRCPC, Associate Professor, Department of Radiation Oncology, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB T6G 1Z2 Alberta, Canada. alysa@ualberta.ca
Telephone: +1-780-4328783 Fax: +1-780-4328380
Received: December 31, 2013
Revised: April 28, 2014
Accepted: July 17, 2014
Published online: December 10, 2014
Revised: April 28, 2014
Accepted: July 17, 2014
Published online: December 10, 2014
Core Tip
Core tip: Palliative radiotherapy (PRT) remains the gold standard for treatment of painful bone metastases from lung cancer. While PRT should be appropriately customized to patients, prescription should also be based on robust evidence. Depending on the clinical scenario, between 4%-66% of survey respondents would use dose-fractionation schedules considered congruent with best available current evidence. These results show a large discrepancy between treatment guidelines and international patterns of practice. It is not completely clear why level 1 data supporting specific dose schedules continues to be overlooked, although reasons for reticence in following these recommendations are reviewed.