Stereotactic body radiation therapy versus multi-fraction radiation therapy for bone metastases

Bone metastases remain one of the most common sites of metastatic cancer spread. Bone metastases can cause considerable pain for patients, which can lead to anxiety, a sense of hopelessness, and depression (1,2). While adequate pain control from cancer-related pain can often be achieved through the use of individualized pain management strategies optimizing analgesic medications (3), many patients require palliative radiotherapy as a means to most optimally control their pain, prevent bone fraction or spinal cord compression, or provide durable tumor control. While the recently evolving landscape of systemic therapies has changed the treatment paradigm for many metastatic patients, the improved response rates and even prolonged survivals seen with target therapies and immunotherapies provide further justification for aggressive pain management of painful bone metastasis and for a local therapy option that provides durable tumor control in metastatic patients who are achieving longer overall survivals.