Bad to the bone.

Treating bone mets in a single radiation treatment makes you look cool, but will it last? An updated meta-analysis of > 6K patients with bone mets treated on trial with single versus multiple fractions reports no difference in complete response (~20%) or any response (~60%) nor in pathologic fractures, future cord compression, or any toxicities. Curiously, retreatment rates more than doubled with single (20%) versus multiple (8%) fractions. This indicates patients who received single fraction were more likely either to have less durable pain control...or to think radiation just isn’t that bad.