Abstract
INTRODUCTION: This study was conducted to compare pain response between single and multiple fraction palliative radiotherapy and to describe prognostic factors affecting treatment response in University of Malaya Medical Centre (UMMC). METHODS: The case records of 162 patients with uncomplicated painful bone metastases treated with palliative radiotherapy from 2006 to 2014 were analyzed. Treatment outcomes were pain score response, analgesic score response, response according to International Consensus Endpoints (complete response and overall response) at 4, 12, and 24 weeks, retreatment rate, symptomatic skeletal events (SSEs), and prognostic factors. RESULTS: At 24 weeks, pain score response for single and multiple fraction group was 82.3% and 88.5%, analgesic score response was 54.8% and 61.5%, and overall response according to International Consensus Endpoint was 61.3% and 67.7%, respectively. There was no statistically significant difference in treatment response between the 2 treatment groups for all endpoints. ECOG (<2 vs ≥2: aOR 3.405, 95% CI 1.708-6.790, P = .001) and primary breast and prostate (breast vs others: aOR 5.231, 95% CI 1.973-13.869, P = .001; prostate vs others: aOR 5.522, 95% CI 1.493-20.420, P = .01) were significant variables on multivariate analysis. CONCLUSION: Single fraction radiotherapy is as effective as multiple fraction radiotherapy for the palliation of uncomplicated bone metastases.