Single fraction image guided radiation therapy for management of bone metastases during the COVID-19 pandemic

Abstract

Aim: Radiation therapy (RT) plays a major role in management of bone metastases, however, various dose-fractionation schemes are utilized taking into account patient, tumor, and treatment characteristics. The aim of this study was to assess Image Guided Single Fraction Radiation Therapy (IG-SFRT) for management of painful bone metastases during the COVID-19 pandemic.
 Material and Method: Patients receiving IG-SFRT for painful bone metastases were assessed for age, gender, primary cancer diagnosis, location of metastases, performance status, analgesic intake, pain relief, and overall treatment efficacy in this study.
 Results: Out of the total 65 patients treated with IG-SFRT during the course of COVID-19 pandemic at our department, 54 patients were evaluable for overall treatment efficacy analysis. Based on the international consensus on palliative RT endpoints, rates of complete response (CR), partial response (PR), pain progression (PP), and indeterminate response (IR) were 16.67%, 59.26%, 9.26%, 14.81%, respectively corresponding to an overall response rate of 75.93%. IG-SFRT was well tolerated by all patients without toxicity.
 Conclusion: For patients with bone metastases, pain palliation is a critical aspect of management. In view of the high rate of overall treatment efficacy achieved with IG-SFRT in our study, we suggest routine utilization of this image guided radiotherapeutic approach for management of painful bone metastases which additionally allows for minimization of treatment visits thereby improving patient and treatment facility convenience under the special circumstances of the recent COVID-19 pandemic.