Radiation therapy for bone metastasis.

Radiation therapy is an important palliative treatment in the management of patients with metastatic bone disease. Excellent results are obtained following radiation therapy to the involved area when generous margins are employed with appropriate megavoltage devices and time-dose-fractionation/protraction. Often an objective response to treatment occurs, as evident by roentgenograms and by pathologic evaluation. Whether the patient's expected life span is relatively short or relatively long, the approach to treatment of bone metastasis must be done within the context of a multidiscipline management. Close cooperation is necessary among radiation oncologists, medical oncologists, orthopedic surgeons, and physiatrists. Radiation therapy for local persistent symptoms relative to bone metastases is an effective technique for achieving long-term control of localized pain without the need for retreatment. Those patients who have a single metastasis with no other evidences of metastatic disease, and who are best treated aggressively, should be differentiated from those patients who have bone metastases as part of a general pattern of metastatic disease where more conservative radiation therapy techniques would be pursued.