[Re-irradiation of painful bone metastases]

Little is known about what the best treatment is for patients returning with painful bone metastases after their first radiotherapy. Treatment should be individualized and should depend on the histology of the primary tumour, the general condition of the patient, systemic treatment options and prognosis. The precise effect of re-irradiation of painful bone metastases has scarcely been studied. A recent meta-analysis published in the Dutch Journal of Medicine sheds only some light on this subject; the meta-analysis provided only some indications as to the effects of re-irradiation, but did not provide any evidence. The studies included were, methodologically speaking, not very strong, as much data were derived from very small numbers of patients. In addition, re-irradiation was never the primary object of study. An international, prospective, randomized clinical trial into the effects of re-irradiation of bone metastases has recently achieved its patient-inclusion target. The first results will be available by the end of 2012; these results will hopefully fill the current gaps in our knowledge.