Journal of Palliative Care & Medicine
Open Access

Research Article

Elderly Patients with Painful Bone Metastases. The Impact of Comorbidity on the Choice of Radiation Therapy Regimen

¹Department of Radiation therapy, National Cancer Institute, Pascale Foundation, Naples, Italy

²Department of Radiotherapy, Second university of Naples, Italy

³Medical Physics Department, National Cancer Institute, Pascale Foundation, Naples, Italy, Naples, Italy

⁴Department of Statistics and Mathematics for the Economic Research, Parthenope University of Naples, Italy

*Corresponding Author:

Maria Giugliano
Department of Radiation therapy
National Cancer Institute
Pascale Foundation, Naples, Italy
Tel: 39-081-5903277
E-mail: fm.giugliano@istitutotumori.na.it

Received date: October 29, 2014; Accepted date: November 07, 2014; Published date: November 16, 2014

Citation: Giugliano FM, Franco RD, Iadanza L, Borzillo V, Cutillo L et al. (2014) Elderly Patients with Painful Bone Metastases. The Impact of Comorbidity on the Choice of Radiation Therapy Regimen. J Palliat Care Med 4:199. doi:10.4172/2165-7386.1000199

Copyright: © 2014 Giugliano FM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background: The aim of this study was to demonstrate comparable pain relief with two schedules of radiotherapy(RT) for painful bone metastases in elderly patients assessed at baseline with the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Materials and methods: 132 elderly were analyzed. 77 received a single 8-Gy fraction and 55 received 20 Gy in 5 fractions. The choice of the treatment schedule was related to comorbidity, disability, target size and compliance. Pain intensity was measured with Numeral Rating Scale (NRS: 0=no pain; 10=high pain). Complete response was defined a pain reduction >3 of three points, partial response as a pain reduction ≥2 (2 ≤ pain reduction ≤ 3), no response was defined by pain score<2. Pain evaluation was recorded at baseline and at 1-4-8 weeks after completing RT. Results: overall response: 90.3% in 8 Gy arm (49.8% complete and 40.5% partial), 94.6% in 20 Gy arm (44.6% complete and 50%partial). No high grade toxicity were reported. The relief of pain was attained faster with single fraction (p-value ~ 0.2). We observed maximum response of pain control after 8 weeks and no significant differences were noted between two groups. The re-treatment rate was 17.6% vs. 11.1% respectively. Conclusions: no significant differences between the two arms in terms of pain response, pain control and toxicity. Our experience showed that not influenced by age, but in the elderly, life expectancy, comorbidities evaluated with the CIRS-G, and compliance, are crucial in selecting of shorter treatment.

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