Impact of dynamic changes to a bone metastases pathway in a large, integrated, National Cancer Institute-designated comprehensive cancer center network

Although our single-fraction utilization rate was initially in line with national rates (7.6%), the adoption rate increased to > 15%. The use of > 10-fraction regimens decreased significantly, predominantly among community practices. By 2014, > 90% of courses were delivered with < 10 fractions. This study demonstrates that provider-driven clinical pathways are able to standardize practice patterns and promote change consistent with evidence-based guidelines.