Single-dose half-body irradiation for the palliation of multiple bone metastases from solid tumors: A preliminary report

The on-going protocol of the Radiation Therapy Oncology group RTOG #78-10, which tests escalating single doses of half-body irradiation (HBI) for the palliation of multiple!,bone metastases, has accrued 108 patients as of August 1980. Of these, 91 patients are evaluable at this time. Low r half-body irradiation (LHBI) was given to 52 patients and another 12 patients received mid-body irradiation (MBI) both LHBI and MBI were targeted to receive escalating doses of 800 rod (27 patients), 900 rod (25 patients), and 1000 rod (12 patients). The latter test dose still required another 13 patients for completion. The remaining 27 patients received upper half-body irradiation (UHBI) with single doses of 600 rod (24 patients), 700 rod (3 patients) and 800 rod (no patients). The 700 rod test dose just opened for accrual and patients will not enter the 800 rodtegory until the lower dose closes with approximately 25 patients. Of the 91 evaluable patients, 36 96 bad breast,596 prostate, and 18% lung primary tumors. Seventy patients (77 96) bad pain relief after HBI, 21% actually had complete subjective responses. Of all relieved patients, 50% achieved pain relief within two days after HBI and aft r a week, almost 80% bad achieved relief. The duration of pain relief was substantial and persisted for 70% of the patient's remaining life. The technique has been well tolerated with mininal toxicity and no treatment-related fatalities were reported in the doses employed. Increasing the dose from 600 rod to 800 rod was beneficial, but 800 rad on (to 900 red or 1000 rod) has not produced better symptomatic responses and may result in increased toxicity. HBI appears to be highly effective in achieving results similar to conventional (2-3 week) radiation with localized fields.