UICC World Cancer Congress 2006

Objective:To examine changes of self-assessed pain scores during palliative radiotherapy of bone metastases and to determine whether MRI imaging is useful in detecting bone metastases and planning of radiotherapy for bone metastases compared to bone scintigraphy.

Methods:From 2003 to 2004, 101 consecutive patients with bone metastases were examined (64 men and 37 women). The median age was 63 years. These patients had 29 lung cancers, 18 prostate cancers, 16 breast cancers, 10 renal cell carcinomas, and others. Patients with bone metastases underwent conventional external radiotherapy, which was performed with 30 Gy in 10 fractions or 40-50 Gy / 20-25 fractions. Pain intensity was evaluated by self-assessed visual analogic scale (VAS) and narcotic score between at the beginning and at the end of radiotherapy. And we compare the usefulness of MRI and bone scintigraphy at detecting bone metastases and planning of radiotherapy.

Results:A significant differences in pain relief was demonstrated by using VAS between vertebral metastases and the other sites of metastases. A straight correlation between narcotic relief and performance status was recognized. MRI imaging detected the most painful metastatic sites rather than bone scintigraphy in this study. Concordance between MRI and bone scintigraphy was not seen in 5 lesions of 87 patients. MRI was superior to bone scintigraphy in treatment planning of vertebral metastases due to invasion outside the vertebra. Palliative radiotherapy was effective for self-assessed pain relief of bone metastases. Results supported the importance of precise imaging that included MRI images of vertebral lesions for the optimum planning of definitive radiotherapy.