Palliative hemibody irradiation in hormonally refractory metastatic prostate cancer

Ten patients with hormonally refractory symptomatic metastatic prostate carcinoma underwent palliative hemibody irradiation (HBI). Four of the patients also had had previous irradiation to symptomatic focal sites. Two of the patients underwent upper body HBI with 5 Gy, while 6 patients underwent lower body HBI with 7 Gy. Two patients received sequential lower body HBI followed by upper body HBI. All 10 patients reported subjective pain relief within the immediate forty-eight to ninety-six hours following therapy. The average response lasted four months. Therefore the majority of our patients achieved symptomatic pain relief for the remainder of their lives which averaged five months (range 1.5-12 months). All 10 patients suffered transient but clinically insignificant hematologic toxicity. There was no death or other significant morbidity attributable to the treatment. We conclude that HBI is safe and effective palliation of bone pain in patients who have failed conventional therapy for prostate cancer.