1338 / 1631
➢
For bony sites, where the goal is limited to symptom relief: a
hypofractionated regimen with a total dose of 8 to 30 Gy (eg, 8 Gy in 1
fraction, 20 Gy in 5 daily fractions, or 30 Gy in 10 daily fractions,
delivered as 5 fractions per week). A single 8 Gy fraction is preferred for
bone disease in patients with poor prospects for survival
➢
Alternatively, conventional fractionation: 20 to 30 Gy in 10 to 15 daily
fractions, at 5 fractions per week. This approach may be preferred if RT
volumes are large or for retreatment
➢
For epidural disease with spinal cord compression, or a bulky mass,
when durable local control is desired: 30 Gy in 10 to 15 daily fractions,
at 5 fractions per week
➢
Spinal radiosurgery may represent an interesting oppirtunity for highly
selected patients (in a reirradiation scenario)
MM Palliation with RT