なぜ単回照射は受け入れられないのか？：エビデンスと実臨床の乖離の要因を考える

Why is single fraction radiotherapy underused?：a perspective on the discrepancy between evidence and practice

本稿では，骨転移に対する放射線治療においてエビデンスと実臨床の乖離が大きいとされる「有痛性骨転移に対する線量分割選択」および「脊髄圧迫に対する手術か放射線治療かの治療法選択」をテーマとして，その要因および解決策に関して検討する。

Based on the results of numerous randomized controlled trials, 8-Gy single fraction is regarded standard therapy for painful bone metastases. On the other hand, it is well-known that single fraction in underused worldwide. The possible reason why singe fraction is underused in Japan may partly be because adequate information is not prevalent. The recommendation about dose fractionations in radiotherapy for painful bone metastases widely differs between clinical guidelines. The uniform recommendation is warranted. It is a difficult question whether surgery or radiotherapy should be performed for patients with metastatic spinal cord compression. Multidisciplinary approach such as cancer board may lead to good decision-making.