How would you manage an osseous lesion that received palliative SBRT with no pain relief?

If there is no pain relief after 9 months, is additional radiation reasonable? What dose/fractionation would be safe and likely to be effective?

Answer from: Radiation Oncologist at Academic Institution

This is certainly a challenging clinical scenario, without meaningful published literature to guide recommendations. If faced with this scenario, I would try to really determine the etiology of the patient’s pain in order to determine the best treatment. First of all, did the patient have pai...

Comments

Radiation Oncologist at Locum Tenens
Rule out Pott's Disease, brucellosis, or other inf...

Radiation Oncologist at Lafayette Radiation Center
Those weren't even on my radar...

Answer from: Radiation Oncologist at Community Practice

I like the thoughtful approach that Dr. @Bradley J. Stish wrote out in terms of considering the etiology of pain and whether radiation is indeed the best next step. It is important to remember that RT is one part of a multimodality approach to cancer care, and that the end goal here is improvin...

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