How to irradiate bone metastases?

Radiotherapy for bone metastases represents an important part of daily practice in Our departments of radiotherapy. Majority of treatments deliver either one fraction (6 to 10Gy) or multifractions mainly using 30Gy in ten fractions. In the past decade, several randomized trials aimed to determine the optimal scheme of radiotherapy in this setting. In the present review, the efficacy of radiotherapy on bone metastases will be evaluated using the following parameters: the partial or complete responses on pain, the reduction of antalgic intake, bone recalcification, and need for reirradiation. Other parameters must also be considered, such as the primary site, number of metastasis, performance status, overall prognosis and side effects of radiotherapy. (C) 2008 Elsevier Masson SAS. Tous droits reserves.