Comparative Study of Single Fraction and Multiple Fraction Palliative Radio Therapy for the Treatment of Bone Metastasis in Multiple Center of Bangladesh

Background: The main goal of palliative radiation treatment is to relief pain or dysfunction caused by bone metastasis. Bone metastasis is a very much painful condition in almost all advanced cancer. This observational study aims to compare the efficacy of different radiation fractionation schedule used for the treatment of bone metastasis. Objective: To compare the single fraction and multiple fraction radiotherapy in the treatment of metastatic bone pain. Method: All patients were explained about the aims, objectives, procedure, risk and benefits of the study. Written informed consent was taken from each patient. Sampling technique was simple random sampling. Every odd number of patients was taken in Group A & every even number patient was taken in Group B. Group A: patients were treated with single (8 Gy) fraction radiotherapy and Group B: patients were treated with multiple fraction (30 Gy) radiotherapy i. e.300 cGy per fraction in 10 fractions, 5days a week for two weeks by tele cobalt or LINAC machine. The responses were, Complete response: Absence of pain. Partial response: decrease of pain. The response and toxicities were evaluated at the end of treatment, after 7days, 14days, 21days, 28days and during the follow - up visits. Result: The total number of 60 patients of metastatic bone disease were studied in two groups. Group A included 30 patients received a single fraction of 8 Gy tumor dose and Group B included 30 patients who received 30 Gy tumor dose in 10 fractions over two weeks. Onset of pain relief was 73.33% in Group A and 76.67% in Group B after completion of 4thweeks radiation. After 8thweeks of radiation 80.00% in Group A and 83.33% in Group B are relieved from pain. Complete response in Group A 46.67% and in Group B 53.33%, partial response in Group A 40% and in Group B 43.33% and overall distribution of no response in Group A 13.33% and in Group B 3.34%. Conclusion: Single fraction palliative radiotherapy is an acceptable alternative for multiple fractions palliative radiotherapy for the control of metastatic bone pain.