Purpose of review: To synopsize the current state-of-the-art for radiation and treatment of painful bone metastases with a focus on prostate cancer.
Recent findings: Although external beam radiation has long been known to palliate painful bone metastatic disease for patients with prostate cancer, new studies continue to evolve in this area. Data from randomized studies over the past decade emphasize that palliation can be achieved with single-fraction radiation strategies. Despite these data, and various supportive national and international guidelines, single-fraction regimens are relatively underutilized in the USA as compared with other countries. In addition to external beam radiation, beta-emitting isotopes are also effective as systemic agents for the palliation of painful bone metastases. New alpha-emitters such as Alpharadin (radium-223) are under current development but remain unproven at this time and recent data indicate that this agent can prolong survival in patients with advanced prostate cancer.
Summary: Radiation in various forms is highly effective for palliation of pain associated with bone metastases.