Pain Flare Following External Beam Radiotherapy of Bone Metastases

 

Patient selection: radiotherapy for bone metastases

 

Features of the pain flare:

(1) increase in bone pain following radiation therapy, often in 3 to 10 days after completion of radiotherapy

(2) return to pre-therapy pain level (or better) or analgesic intake over time (to distinguish pain flare from disease progression)

 

Chow et al (2005) defined the pain of a pain flare as:

(1) 2 point increase in a 10 cm pain VAS without a decrease in analgesic intake

(2) 25% increase in opioid intake without a decrease in pain score

 

Dexamethasone therapy can significantly decrease the pain flare.