Effectiveness of Palliative Radiotherapy in Pain Relief and Reduction of Analgesic Dependence among Patients with Painful Bone Metastases: A Prospective Observational Study

Abstract

Background:  Bone metastases are a common complication of advanced malignancies and are frequently associated with severe pain, reduced mobility, impaired quality of life, and increased analgesic dependence. Palliative radiotherapy is an established modality for symptomatic relief in these patients.

Aim: To evaluate the effectiveness of palliative radiotherapy in achieving pain relief, reducing analgesic dependence, and improving quality of life among patients with painful bone metastases.

Materials and Methods: This prospective observational study was conducted in the Department of Radiation Oncology of a tertiary care center over a period of two years. A total of 68 patients aged 30–80 years with painful bone metastases from various primary malignancies were included. Pain intensity was assessed using the Visual Analogue Scale (VAS), while analgesic dependence and quality-of-life parameters were evaluated during follow-up. Patients received either single-fraction or multiple-fraction external beam radiotherapy. Follow-up assessments were performed at 10 days, 2 weeks, 4 weeks, 2 months, 6 months, 1 year, and 2 years after treatment.

Results: In patients with painful bone secondaries , breast carcinoma was the most common primary malignancy, followed by lung and prostate carcinoma. Significant pain relief was observed as early as 10 days following radiotherapy, with maximal response noted between 2 and 4 weeks. Complete pain relief was achieved in 35.3% patients, while 48.5% showed partial relief. Reduction in analgesic dependence was observed in 85.3% of patients. Overall quality of life improved in 76.5% patients. Refractory pain requiring further intervention was noted in 16.2% cases. Comparable efficacy was observed between single- and multiple-fraction radiotherapy schedules.

Conclusion: Palliative radiotherapy provides effective pain control, reduces opioid dependence, and improves quality of life in patients with painful bone metastases, with both single and multiple fractionation schedules demonstrating similar clinical outcomes.