Meta-analysis of studies of stereotactic body versus conventional radiotherapy for painful bone metastases

Conventional external beam radiotherapy (cEBRT) and stereotactic body radiotherapy (SBRT) are commonly used options for relieving metastatic bone pain. There is no consensus on the relative effectiveness of both types of radiotherapy for relieving metastatic bone pain. A systematic review and meta-analysis of 8 randomized clinical trials with 1090 patients found that the overall pain response did not differ significantly between patients treated with cEBRT and SBRT after 1, 3, or 6 months. At all three time points, more patients experienced complete pain alleviation after SBRT compared with cEBRT. The authors conclude that this analysis does not support the routine use of SBRT for all patients with painful bone metastases, but that selected subgroups may benefit from SBRT.