Comparative Evaluation of Two Different Single-Session Radiotherapy Regimens along with Zoledronic Acid in Painful Bone Metastases

Bone metastases frequently occur in various types of cancer. External beam radiotherapy (EBRT) effectively alleviates the pain associated with these metastases. Various experimental studies have been conducted to see the effectiveness of single-session radiation along with bisphosphonates to control the pain of bone metastasis. In the present study, we compared two schedules of palliative EBRT in painful bony metastasis. We conducted a prospective study involving patients with bone metastases from any primary cancer. Patients were randomly assigned to receive palliative EBRT at either 8 Gy single session (group I) or 6 Gy single session (group II), along with zoledronic acid administered to the involved site in both groups. The primary objective was to evaluate overall pain response using the Glasgow pain scale and improvement in performance status measured by the Eastern Cooperative Oncology Group (ECOG) performance status score. Secondary objectives included assessing complete pain relief and the duration of overall pain response. A total of 60 patients were equally randomized into two groups. Group I showed the highest degree of pain relief. In both groups, there was a significant reduction in mean baseline pain score, and the mean ECOG performance status improved at the 1-month post-EBRT assessment. Our analysis showed that both single-session schedules of EBRT with zoledronic acid effectively alleviate painful bone metastases, offering viable options based on individual patient tolerability and compliance.