A man in the advanced prostate cancer online support group has asked, “Why the radiation (external beam to relieve bone pain from prostate cancer and to protect the bones from fractures) is given in so many “mini” doses rather than one or two larger doses.
The answer is it doesn’t necessarily have to be delivered in many smaller dosages.
Guidelines from the American Society for Radiation Oncology (ASTRO) support treatment with a single fraction of radiation using a dose of 8 Gy to provide palliation for relief of pain from bone metastases in men with prostate cancer.
Based upon a systematic review of the literature, this approach improved patient convenience and was more cost effective compared with fractionated schedules [1]. The use of a single 8 Gy fraction for pain relief is also supported by a second systematic review of the literature that looked at different doses of radiation administered as a single fraction [2]. That review also concluded that a dose of 8 Gy was more effective than lower doses in providing pain relief.
The ASTRO Guideline
“External beam radiotherapy has been, and continues to be, the mainsta