The use of palliative radiotherapy for bone metastasis

BackgroundThe value of palliative radiotherapy (PRT) for bone metastases is well established, but little is known about its use in the general population.PurposeTo describe the use of PRT for bone metastases in Ontario.Materials and methodsThis was a retrospective cohort study. Treatment records from all Ontario RT departments were linked to a population-based cancer registry to describe the use of PRT.Results12.2% of the 434,241 patients, who died of cancer in Ontario between 1984 and 2004, received at least one course of PRT for bone metastases in the last 2 years of life. The rate of use of PRT varied across the province (inter-county range, 8.2–18.6%). Older patients and residents of poorer areas were less likely to receive PRT (p < 0.0001). Patients diagnosed with cancer in a hospital with a radiotherapy facility and those who lived closer to a radiotherapy centre were more likely to receive PRT (p < 0.0001). Over the study period, the use of PRT decreased in breast cancer and myeloma, but increased in prostate cancer (p < 0.0001).ConclusionsAccess to PRT appears to be inequitable. More effort is required to make this useful treatment available to all those who would benefit from it.