Prospective trials for the radiotherapeutic treatment of bone metastases.

Radiation therapy is a proven technique to relieve the pain of bone metastases. Focal painful metastases can be palliated in up to 80 percent of patients. The technique to use for the treatment varies depending on the extent of disease, the prognosis of the patient and physician preference. Most studies indicate that the local treatment of bone metastases with single large treatments is as efficacious as extended courses of treatment. For patients with wide-spread disease, two forms of systemic radiotherapy are available: hemibody irradiation and intravenous injection of radionuclides. Studies have shown the combination of either focal irradiation and hemibody irradiation or focal irradiation and the injection of strontium (89) prolongs the pain-free duration of the patients. All palliative patients with symptomatic bone metastases should be evaluated for radiotherapy.