*Palliative Therapy of Bone Metastases DOI: http://dx.doi.org/10.5772/intechopen.107895*

external radiotherapy is the exposure of healthy tissues to radiation and unnecessary absorbed dose in these tissues, which can lead to acute complications [25]. In terms of relieving bone pain, local irradiation is without doubt effective. Approximately 85% of patients report complete relief of pain, with half reporting complete relief. Within 1–2 weeks, more than half of responders experience pain relief. Improvement in pain is unlikely to occur if it hasn't been achieved by 6 weeks or more after treatment [26]. It is common to use single treatments or short fractionation schedules in Canada and Europe rather than prolonged fractionated treatments in the United States. Treatment techniques and doses have varied considerably throughout history, with prolonged fractionated treatments preferred in the United States. Fractionation schedules have been compared in a number of randomized trials. The pain relief offered by each approach was not superior. According to several studies, fractionated vs. single treatments do not differ in toxicity, pain response, analgesic consumption, adverse effects, or quality of life when compared with single treatments, including a large Dutch study of 1157 patients with painful bone metastases. 76 No statistically significant differences were found for pain response, analgesic consumption, treatment adverse effects, or quality of life [27].

After a meta-analysis comparing single fraction versus multiple fractions, it was revealed that both single fraction and multiple fractions achieved similar symptomatic responses; 1011 of 1391 (73%) receiving a single fraction and 958 of 1321 (73%) receiving multiple fractions. thus, for many patients suffering from painful bone lesions, single-fraction radiotherapy is a viable treatment option [28].
