ArticleInternational journal of radiation oncology, biology, physics2014
Use of single- versus multiple-fraction palliative radiation therapy for bone metastases: population-based analysis of 16,898 courses in a Canadian province.
Article in International journal of radiation oncology, biology, physics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Global burden of pain in malignant bone tumors: a meta-analysis of severity and health outcomes.Frontiers in oncology · 2026Pooled it
- Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Review
- Practice Patterns of Palliative Radiotherapy for Advanced Cancer at a Large Institute in Saudi Arabia.Palliative medicine reports · 2025Article
- Factors Affecting Survival and Local Control in Patients with Bone Metastases Treated with Radiotherapy.Medical sciences (Basel, Switzerland) · 2023Article
- Evaluation of Patient-Reported Outcome Differences by Radiotherapy Techniques for Bone Metastases in A Population-Based Healthcare System.Current oncology (Toronto, Ont.) · 2022Article
- Prognostic Factors Influencing Survival and a Treatment Pattern Analysis of Conventional Palliative Radiotherapy for Patients with Bone Metastases.Current oncology (Toronto, Ont.) · 2021Article
- Article
- Fraction Size: a New Paradigm for Radiotherapy Payment.Journal of Korean medical science · 2019Article
- Review
- Are radiation oncologists following guidelines? An audit of practice in patients with uncomplicated bone metastases.Technical innovations & patient support in radiation oncology · 2019Article
- Choosing Wisely at the End of Life: Use of Shorter Courses of Palliative Radiation Therapy for Bone Metastasis.International journal of radiation oncology, biology, physics · 2018Article
- Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital-based analysis of patterns of care, RT fractionation scheme, and overall survival.Cancer medicine · 2018Article
- Single vs multiple fraction palliative radiotherapy for uncomplicated painful bone metastases treated at University of Malaya Medical Centre: A single institutional Malaysian experience.Aging medicine (Milton (N.S.W)) · 2018Article
- The Glasgow prognostic score: Useful information when prescribing palliative radiotherapy.Molecular and clinical oncology · 2017Article
- Spine Metastasis Practice Patterns among Korean, Chinese, and Japanese Radiation Oncologists: A Multinational Online Survey Study.Journal of radiation research · 2017Article
- Use of low-value radiotherapy practices in Canada: an analysis of provincial cancer registry data.Current oncology (Toronto, Ont.) · 2016Article
- Variation in Practice Patterns of Korean Radiation Oncologists for Spine Metastasis between 2009 and 2014.Cancer research and treatment · 2016Article
- Utilization of palliative radiotherapy for bone metastases near end of life in a population-based cohort.BMC palliative care · 2016Article
- Incidence of distal bone metastases in patients treated for palliative radiotherapy and associations with primary tumour types.Journal of bone oncology · 2015Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThere is abundant evidence that a single fraction (SF) of palliative radiation therapy (RT) for bone metastases is equivalent to more protracted and costly multiple fraction courses. Despite this, there is low utilization of SFRT internationally. We sought to determine the utilization of SFRT in a population-based, publicly funded health care system. METHODS AND MATERIALS: All consecutive patients with bone metastases treated with RT during 2007 to 2011 in British Columbia (BC) were identified. Associations between utilization of SFRT and patient and provider characteristics were investigated.
resultsA total of 16,898 courses of RT were delivered to 8601 patients. SFRT was prescribed 49% of the time. There were positive relationships among SFRT utilization and primary tumor group (P<.001; most commonly in prostate cancer), worse prognosis (P<.001), increasing physician experience (P<.001), site of metastases (P<.001; least for spine metastases), and area of training (P<.001; most commonly for oncologists trained in the United Kingdom). There was wide variation in the prescription of SFRT across 5 regional cancer centers, ranging from 25.5% to 73.4%, which persisted after controlling for other, potentially confounding factors (P<.001).
conclusionsThe large variability in SFRT utilization across BC Cancer Agency (BCCA) cancer centers suggests there is a strong cultural effect, where physicians' use of SFRT is influenced by their colleagues' practice. SFRT use in BC was similar to that in other Canadian and western European reports but strikingly higher than in the United States. Further work is needed to standardize SFRT prescribing practices internationally for this common indication for RT, with the potential for huge health system cost savings and substantial improvements in patients' quality of life.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.