5.2.1.2 Wide-Field Radiation Therapy
Hemibody irradiation, which can treat multiple disease sites, is particularly
appropriate for diffuse bone pain. A single large fraction of 6 Gy to 8 Gy is
administered to one half of the body. If necessary, the other half can be
treated after a 3-week interval to allow for bone marrow recovery. With
antiemetics and partial shielding to reduce lung exposure, toxicity occurs in
fewer than 10 percent of patients, and 50 percent experience stabilization of
disease at 1-year followup (Poulter, Cosmatos, Rubin, et al., 1992). Salazar,
Rubin, Hendrickson, et al. (1986) reported that palliation was achieved in 73
percent of patients treated with hemibody irradiation, and pain recurrence was
lower than that reported in an earlier uncontrolled study of the palliative
effects of local radiotherapy (Tong, Gillick, Hendrickson, 1982). This analysis
is consistent with other reported studies with hemibody irradiation in which 50
percent of patients report at least partial pain relief within 48 hours of
treatment with an eventual total response rate of 55 to 100 percent (Kuban,
Schellhammer, and el-Mahdi, 1991; Salazar, Rubin, Hendrickson, et al., 1986).
Exercise
Radiation Therapy
Bone Metastases
Pain Relief with Localized Radiation Therapy
Radiopharmaceuticals
Plexopathy
Other Therapeutic Applications
Surgical Management of Pain due to Primary or Metastatic Tumor
Index