Palliative Radiation Therapy for Bone Metastases: Update of an Astro Evidence-Based Guideline

A clinical practice guideline for the use of palliative radiation therapy (RT) in adults with bone metastases. The guideline discusses the appropriateness of different fractionation schemes depending on clinical context, and examines the risks of experiencing long-term side-effects associated with single fractionation. The efficacy of advanced RT techniques for initial treatment and retreatment is also discussed, and the guideline examines the potential impacts that surgery, radionuclides, bisphosphonates, and kyphoplasty/vertebroplasty have on the appropriateness of palliative RT. Outcomes of interest include reductions in pain, spinal cord compression, hypercalcemia, and pathologic fracture.