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Palliative RT Bone — SCE Medical Oncology MCQ

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EasyBreast CancerPalliative RT BoneSCE Medical Oncology

A 62-year-old woman with ER+/HER2- breast cancer develops vertebral metastases causing back pain. She is started on an opioid and a bone-targeted agent. Her oncologist also prescribes radiotherapy to the painful vertebra. What is the expected response rate and timing for palliative radiotherapy to bone metastases?

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Correct answer: C — Approximately 60-80% of patients achieve pain improvement

Palliative radiotherapy for painful bone metastases provides pain relief in approximately 60-80% of patients (complete response in ~25-30%). The RTOG 97-14 and Dutch Bone Metastasis trial showed that single-fraction RT (8 Gy in 1 fraction) provides equivalent pain relief to multi-fraction regimens (20 Gy/5 or 30 Gy/10) for uncomplicated bone metastases. Single fraction is preferred for: convenience, cost-effectiveness and patient burden reduction. Multi-fraction may be preferred for: MSCC risk, neuropathic component, or re-irradiation concerns.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer