Do not use, to the extent possible, prolonged radiation therapy for palliative treatments in frail patients with a short life expectancy

Type of practice

Other treatments

Topic Area


Several clinical studies showed that a prolonged treatment regimen including radiotherapy and/or chemotherapy does not provide any survival benefit in cancer patients having a short life expectancy.
However, radiotherapy plays a crucial role in providing patients with symptoms relief, with a high chance of clinical benefit (in case of pain, bleeding, and spinal cord compression).
Nevertheless, prolonged treatment regimens may reduce the available lifetime for patients outside the hospital, with consequent detrimental effects on patient’s quality of life and family balance. Hence, radiotherapy should be given employing short schedules in these clinical settings.


1. La Radioterapia nel trattamento delle metastasi ossee (Linee Guida AIOM-AIRO)
2. ACR Appropriateness Criteria ® spinal bone metastases. Expert Panel on Radiation Oncology-Bone Metastases, Lo SS, Lutz ST, Chang EL, Galanopoulos N, Howell DD, Kim EY, Konski AA, Pandit-Taskar ND, Rose PS, Ryu S, Silverman LN, Sloan AE, Van Poznak C. J Palliat Med. 2013 Jan; 16(1): 9-19.
3. ACR Appropriateness Criteria® non-spine bone metastases. Expert Panel On Radiation Oncology-Bone Metastases, Lutz ST, Lo SS, Chang EL, Galanopoulos N, Howell DD, Kim EY, Konski AA, Pandit-Taskar ND, Ryu S, Silverman LN, Van Poznak C, Weber KL. J Palliat Med. 2012 May; 15(5): 521-6.
4. Lutz S, Berk L, Chang E, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 2011; 79(4): 965e976.



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