[Optimal doses and timing for tele-irradiation of bone metastases in patients with life expectancy more than 3 months].

The aim of the current study was to improve the bone metastases irradiation parameters in patients with life expectancy more than 3 months. The current randomized study included a total of 333 patients with bone metastases (breast cancer metastases in 71% of cases) receiving 488 courses of photon irradiation. Irradiation effect was observed in 95.8-100% of cases regardless of fraction number and irradiation regimen. The rate of complete effect was the same for all irradiation regimens, but raised gradually from 33.3% to 50.4% and 65.9% respectively when irradiation was given by 2, 3 and 4 fractions, 6,5 Gy each (p < 0.03); 78.4% (p < 0.01) cases of complete effect were observed in patients receiving irradiation by multiple small fraction compared to the groups receiving irradiation by 2 or 3 fractions of 6.5 Gy. The complete effect was more often observed in breast cancer (67%) and prostate cancer (63%) patients in comparison to lung cancer (47%) and renal cancer (30%) patients (p < 0,05) independent of metastases localization. The mean frequency of pain recurrence in irradiated area was 8.2% in all primary tumor and metastases localizations, irrespective of irradiation dose and regimen. Based on above results we recommend for breast cancer and prostate cancer patients with bone metastases and life expectancy more than 3 months the irradiation with 19.5 Gy given by 3 fractions. The patients with metastasizing lung and renal cancer should receive 26 Gy irradiation by 4 fractions 6.5 Gy each given once every 5.