ReviewJournal of bone oncology2014
International patterns of practice in radiotherapy for bone metastases: A review of the literature.
Review in Journal of bone oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07772206 (The SMART Trial), which is not on this map. Cited by 18 papers, 1 of them a synthesis 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.
The SMART Trial: A Randomised Feasibility Study Comparing Single Fraction and Multifraction Arc-Based Radiotherapy for Painful Bone Metastases
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global research trends in radiotherapy for bone metastases: a systematic bibliometric analysis.Frontiers in oncology · 2025Pooled it
- Single-Fraction Stereotactic vs Conventional Multifraction Radiotherapy for Pain Relief in Patients With Predominantly Nonspine Bone Metastases: A Randomized Phase 2 Trial.JAMA oncology · 2019Trial
- Trends in radiotherapy fractionation for bone metastases: a multi-center study of practice patterns before, during, and after COVID-19.Radiation oncology journal · 2026Article
- Practice Patterns of Palliative Radiotherapy for Advanced Cancer at a Large Institute in Saudi Arabia.Palliative medicine reports · 2025Article
- Prognostic Factors Influencing Survival and a Treatment Pattern Analysis of Conventional Palliative Radiotherapy for Patients with Bone Metastases.Current oncology (Toronto, Ont.) · 2021Article
- Creation of clinical algorithms for decision-making in oncology: an example with dose prescription in radiation oncology.BMC medical informatics and decision making · 2021Review
- Adoption of single fraction radiotherapy for uncomplicated bone metastases in a tertiary centre.Clinical and translational radiation oncology · 2021Article
- Palliative Radiation for Cancer Pain Management.Cancer treatment and research · 2021Article
- The advantages of carbon fiber based orthopedic devices in patients who have to undergo radiotherapy.Acta bio-medica : Atenei Parmensis · 2020Article
- The efficacy of three-dimensional conformal radiation therapy on pain and quality of life in patients with painful bone metastases: a prospective study.Croatian medical journal · 2020Article
- Letter from Switzerland.International journal of radiation oncology, biology, physics · 2020Article
- Article
- 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
- Use of low-value radiotherapy practices in Canada: an analysis of provincial cancer registry data.Current oncology (Toronto, Ont.) · 2016Article
- Impact of curative radiotherapy on the immune status of patients with localized prostate cancer.OncoimmunologyArticle
- Prognostic Score in Radiotherapy Practice for Palliative Treatments (PROPHET) Study for Bone Metastases: An Investigation Into the Clinical Effect on Treatment Prescription.Advances in radiation oncologyArticle
- Palliative radiation and fractionation in medicare patients with incurable non-small cell lung cancer.Advances in radiation oncologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRadiation therapy is the standard treatment for symptomatic bone metastases. Several randomized control trials and meta-analyses have concluded a similar efficacy in pain relief when comparing single versus multiple fraction regimes. However, there continues to be reluctance to conform to published guidelines that recommend a single treatment for the palliation of painful bone metastases. The purpose of this literature review is to summarize international patterns of practice, and to determine if guidelines recommending single fraction treatment have been implemented in clinical care.
methodsA literature search was conducted in Ovid Medline, Embase, and Cochrane Central. Search words included, 'bone metastases', 'radiation therapy', 'radiotherapy', 'patterns of practice', and 'dose fractionation'. Both prospective and retrospective studies that investigated the prescription of radiotherapy to bone metastases using actual patient databases were included. Articles were excluded if they investigated hypothetical scenarios.
resultsSix hundred and thirteen results were generated from the literature search. Twenty-six articles met the inclusion criteria. Of these, 11 were Canadian, 8 were European, 6 were American, and 1 was Australian. The use of single fraction radiotherapy (SFRT) ranged from 3% to 75%, but was generally lower in American studies. Choice of fractionation depended on a variety of factors, including patient age, prognosis, site of irradiation, and physician experience.
conclusionDespite the publication of robust randomized control trials, meta-analyses, and clinical practice guidelines recommending the use of a single treatment to palliate uncomplicated bone metastasis, SFRT is internationally underutilized.
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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.