Palliative radiotherapy of bone metastases in gynecological malignancies
Affiliation and adress for correspondence

Correspondence to: Klinika Nowotworów Narządów Płciowych Kobiecych Centrum Onkologii – Instytut im. M. Skłodowskiej-Curie w Warszawie, ul. Roentgena 5, 02-781 Warszawa.
Kierownik Kliniki: doc. dr hab. med. Mariusz Bidziński
Source of financing: Department own sources

GIN ONKOL, 2005, 3 (1), p. 47-52

In spite of significant progress in diagnostic and therapeutic methods, bone metastases are still the diagnostic and therapeutic problem. They do not give any uniform clinical signs. They may be asymptomatic in some cases, in the others, they are very painful and may cause pathological fractures. The treatment method employed in these events has a significant meaning. The aim of the study was the bone metastases frequency in gynecological malignancies analysis and the assessment of direct analgesic effect of palliative irradiation. Material and method: The subject of analysis was the group of 1359 patients with gynecological malignancies, treated between 1996 and 1998 at Gynecological Department of Maria Sklodowska-Curie Memorial Cancer Centre in Warsaw. All diagnoses were confirmed with histopathological examination, clinical exams and the digital exams. The clinical stage was assessed according to FIGO classification. They were qualified to the intent – to treat treatment, according to in force protocols. From the above group, 20 patients with bone metastases were separated. In all cases, palliative radiotherapy with analgesic intent was performed. Photons γ Co60, or X energized 4, 9 or 15 MeV, with one or two – field technique. The hypo fractionation schemes were performed: 3, 4, 8 Gy per fraction, suitably in 10, 5 or 1 fraction. The analgesic effect was evaluated, based on the subjective patient’s opinion and the analgesic drugs limitation possibility. Results: Direct analgesic effect was obtained in 17/20 (85%) patients. The fractionation scheme had no influence on direct analgesic effect. Conclusions: External beam irradiation is an effective palliative treatment of pain caused by bone metastases. The fractionation schedule has no significant influence on analgesic effect.

Keywords: palliative radiotherapy, bone metastases, gynecological malignancies, hypofractionation, analgesic effect