COMPARATIVE EVALUATION OF EFFICACY OF PALLIATIVE RADIATION THERAPY WITH DEXAMETHASONE VERSUS PALLIATIVE RADIATION THERAPY ALONE FOR PAIN FLARES IN PAINFUL BONE METASTASIS

Sunder Singh, Rakesh Dhankhar, Kiran Dahiya*, Keerti Gupta, Sanghapriya Pal and Anil Khurana

ABSTRACT

Development of pain flares is a common association with palliative radiotherapy for management of bone metastasis. Dexamethasone, a hydrocortisone with anti-inflammatory property, holds a potential for prevention of pain flare in these patients when used as an adjuvant therapy. The study was conducted on 60 patients divided randomly into 2 groups of 30 patients each. Group I patients received palliative external radiation therapy 20 Gy in 5 fractions for 5 days with tablet dexamethasone 8mg orally one to five days while group II patients received palliative radiation therapy only. All the patients were followed every day for 5 days and then monthly for 6 months for occurrence of pain flare. Group I patients were observed to have reduced pain flare (p<0.05), less requirement of analgesics (p<0.05), overall better pain relief (p<0.05) and lesser need of re-irradiation as compared to those in group II. Thus, dexamethasone may be used as an adjuvant to standard palliative radiotherapy for the management of painful bone metastasis though the claim is still debated and needs substantiation with more supportive studies.

Keywords: Pain flare, Dexamethasone, Palliative Radiotherapy, Painful bone metastasis.