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Radiotherapy Onset and Duration for Bone Pain — SCE Palliative Medicine MCQ

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EasyPain ManagementRadiotherapy Onset and Duration for Bone PainSCE Palliative Medicine

A 72‑year‑old man with advanced colorectal cancer has cancer‑related bone pain from multiple metastases. He is on morphine MR 60 mg BD, paracetamol, and naproxen with PPI. His oncologist offers a single fraction of palliative radiotherapy. What is the expected onset and duration of radiotherapy‑induced pain relief?

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Correct answer: C — Onset typically within 1–4 weeks, with pain relief lasting for weeks to a few months and approximately 60 % of patients responding

Multiple high‑quality trials and systematic reviews show that single‑fraction palliative radiotherapy for bone metastases achieves pain relief in around 60 % of patients, typically beginning within 1 to 4 weeks and sustained for several weeks to a few months. Pain is not immediate (ruling out B), not universally complete or permanent (ruling out C and D), and is definitely not absent (ruling out E). Option C accurately summarises the onset, duration and response rate.

Reference: Sze WM et al. Systematic review of single versus multifraction palliative radiotherapy for bone metastases – overall response ~60 % (2003); Kaasa S et al. Randomised trial showed pain relief by 4 weeks, maintained to 28 weeks (2006)