A 72-year-old man with metastatic castration-resistant prostate cancer has a painful T8 vertebral metastasis without spinal cord compression or neurological deficit. His performance status is ECOG 3. What is the recommended radiation fractionation for palliation of this painful bone metastasis?
- A 30 Gy in 10 fractions
- B 20 Gy in 5 fractions
- C Single fraction of 8 Gy ✓
- D 40 Gy in 20 fractions
Correct answer: C. Single fraction of 8 Gy
Explanation
Single-fraction radiotherapy (8 Gy) is recommended for painful bone metastases in patients with poor performance status and limited life expectancy, as it provides equivalent pain relief to fractionated regimens while minimizing hospital visits. Multiple randomized trials and ASTRO guidelines support this. Fractionated schedules may be considered for patients with better prognosis or when retreatment is anticipated.
Reference: Perez and Brady's Principles and Practice of Radiation Oncology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.