Palliative Radiotherapy for Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 December 2025 | Viewed by 629

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Guest Editor
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
Interests: radiation medicine; palliation; symptom control; oligometastases; theranostics
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Special Issue Information

Dear Colleagues,

Radiation therapy has long been used for palliation in cancer. Traditionally, clinical practice has focused on the relief of symptoms while causing the fewest side effects and most minimal treatment burden, with an emphasis on the principle that time is precious when life is short. In modern practice, with the increasing adoption of advanced technologies, sophisticated treatment techniques such as VMAT, SBRT, SFRT are no longer restricted to the care of patients with curable cancers. While local control for metastatic lesions is not generally a care objective, defining the situations where this is  supported by the careful choice of outcome measures is required to guide modern practice. Novel applications of radiotherapy that can influence the trajectory of metastatic processes and, hence, the patients’ cancer journey and quality of life are increasingly being investigated. The rapid growth of radiotheranostics provides us with another exciting tool that is  capable of both relieving symptoms and changing the clinical course of metastatic disease. In this Special Issue, we welcome original research articles, high-quality systematic reviews and meta-analyses that will expand our understanding of how radiation therapy can improve the journeys of cancer patients and reduce their symptom burden in both the short and long term, with a strong focus on patient reported outcomes. Translational work that will support clinical studies in this field is also welcome.

Prof. Rebecca Wong
Guest Editor

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Keywords

  • symptom relief
  • symptom control
  • radiation medicine
  • radiotheranostics
  • theranostics
  • external beam radiotherapy
  • palliation
  • oligometastases
  • oligoprogression
  • systematic reviews and meta-analyses
  • patient reported outcomes
  • abscopal effect
  • combined modality
  • education
  • clinical practice

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Published Papers (1 paper)

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Research

14 pages, 1032 KiB  
Article
Accelerated Radiotherapy for Complicated Bone Metastases: SHARON Bone Randomized Phase III Trial Shows Non-Inferiority Compared to Standard Palliative Fractionation (NCT03503682)
by Alice Zamagni, Giambattista Siepe, Dino Gibertoni, Costanza M. Donati, Francesco Cellini, Francesco Fiorica, Donato Pezzulla, Francesco Deodato, Filippo Candoli, Silvia Bisello, Erica Scirocco, Stefania Manfrida, Milena Gabbani, Savino Cilla, Gabriella Macchia and Alessio G. Morganti
Cancers 2025, 17(12), 2000; https://doi.org/10.3390/cancers17122000 - 16 Jun 2025
Viewed by 355
Abstract
Objective: The SHARON (Short course RadiatiON therapy for palliative treatment) Bone trial is a phase III randomized non-inferiority multicentric study comparing symptom relief for complicated bone metastases (BMs) achieved through hypofractionated accelerated palliative radiotherapy (RT) to a standard RT regimen. Methods: Eligible [...] Read more.
Objective: The SHARON (Short course RadiatiON therapy for palliative treatment) Bone trial is a phase III randomized non-inferiority multicentric study comparing symptom relief for complicated bone metastases (BMs) achieved through hypofractionated accelerated palliative radiotherapy (RT) to a standard RT regimen. Methods: Eligible participants were adults with ECOG PS ≤ 3 who were referred for palliative RT for painful BMs. Patients were assigned to receive either 30 Gy delivered in 10 daily fractions or 20 Gy in 4 fractions over two consecutive days. The primary outcome was pain relief one month post-treatment. Pain relief and adverse events were also evaluated at 2, 3, 6, and 12 months after RT. This trial was registered at clinicaltrials.gov (NCT03503682). Results: Between February 2018 and November 2021, 83 patients were enrolled (30 Gy: 41; 20 Gy: 42). In the standard RT group, five patients did not complete the prescribed RT, while none in the experimental arm discontinued treatment (p = 0.026). Due to early mortality, the primary endpoint was evaluable in 73 patients (35 and 38 in the standard and experimental arms, respectively). The rate of complete pain response at one month was 22.9% and 28.9% in the 30 Gy and 20 Gy arms, respectively (p: 0.571). The overall pain response rates, which included complete and partial responses, were 74.3% and 78.9% in the 30 Gy and 20 Gy arms, respectively (p = 0.638), when considering at least a 2-point reduction in the numerical rating scale. In both arms, 4.8% of patients experienced Grade >2 toxicity. Conclusions: Administering 20 Gy in four fractions twice a day is non-inferior to the standard 30 Gy delivered in 10 fractions for pain relief in the context of complicated BMs. Furthermore, this regimen demonstrated comparable safety in terms of acute toxicity, with a lower incidence of definitive interruptions of radiotherapy. Full article
(This article belongs to the Special Issue Palliative Radiotherapy for Cancer)
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