Don’t use, to the extent possible, prolonged radiation therapy treatments when the purpose of radiation therapy is symptomatic and palliative in people with reduced life expectancy.

Type of practice

Other treatments

Topic Area


Numerous clinical studies have documented that, in patients with reduced life expectancy, prolonged chemo-and radiotherapy-based treatments are ineffective in terms of increased survival. Radiation therapy has conversely a key role in the management of complications related to the spread of disease in patients with a short life expectancy (eg. pain, bleeding, spinal cord compression, etc ..) because it is characterized by high response rates with consequent improvement quality of life even in patients with advanced disease.
However, prolonged treatments performed in these clinical situations reduce the life time available outside of medical services (since it involves a prolongation of hospitalization or access to the radiotherapy department), creating discomfort to the patient and the family, while similar results can be obtained with shorter treatments and consequently should be avoided as much as possible.


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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