BACKGROUND AND PURPOSE: Numerous randomized controlled trials and meta-analyses have affirmed that single and multiple fractions of radiotherapy provide equally efficacious outcomes in the palliation of painful, uncomplicated bone metastases (UBM). We aim to determine geographic, temporal and ancillary factors that influence the global patterns of practice in this setting. MATERIALS AND METHODS: A literature search was conducted on Ovid MEDLINE and EMBASE. Studies were included if they disclosed prescription patterns of single fraction radiotherapy, either through hypothetical cases or actual patient data. Weighted analysis of variance was conducted for binary predictors while weighted linear regression analysis was performed for continuous parameters. RESULTS: Nine hypothetical case studies and thirteen actual patterns of practice articles were included from 301 search results. Radiation oncologists prescribed dose fractionations ranging from 3Gy×1 to 2Gy×30, with a median of 3Gy×10, for the palliation of UBM. Actual data demonstrated a weak, non-significant, negative linear relationship between the use of single fraction radiotherapy and the year of treatment. Geographical location of treatment was a key predictor of prescription patterns. CONCLUSION: In the last twenty years, there was an overall global reluctance to practice evidence-based medicine by employing single fractions for UBM.
BACKGROUND AND PURPOSE: Numerous randomized controlled trials and meta-analyses have affirmed that single and multiple fractions of radiotherapy provide equally efficacious outcomes in the palliation of painful, uncomplicated bone metastases (UBM). We aim to determine geographic, temporal and ancillary factors that influence the global patterns of practice in this setting. MATERIALS AND METHODS: A literature search was conducted on Ovid MEDLINE and EMBASE. Studies were included if they disclosed prescription patterns of single fraction radiotherapy, either through hypothetical cases or actual patient data. Weighted analysis of variance was conducted for binary predictors while weighted linear regression analysis was performed for continuous parameters. RESULTS: Nine hypothetical case studies and thirteen actual patterns of practice articles were included from 301 search results. Radiation oncologists prescribed dose fractionations ranging from 3Gy×1 to 2Gy×30, with a median of 3Gy×10, for the palliation of UBM. Actual data demonstrated a weak, non-significant, negative linear relationship between the use of single fraction radiotherapy and the year of treatment. Geographical location of treatment was a key predictor of prescription patterns. CONCLUSION: In the last twenty years, there was an overall global reluctance to practice evidence-based medicine by employing single fractions for UBM.
Authors: A Rodríguez; J M Borrás; J López-Torrecilla; M Algara; A Palacios-Eito; A Gómez-Caamaño; L Olay; P C Lara Journal: Clin Transl Oncol Date: 2016-08-04 Impact factor: 3.405
Authors: Jeong Il Yu; Hee Chul Park; Yong Chan Ahn; Yoonsun Chung; Woong Sub Koom; Si Yeol Song Journal: Cancer Res Treat Date: 2015-12-02 Impact factor: 4.679