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Review
. 2024 Aug 28:49:100845.
doi: 10.1016/j.ctro.2024.100845. eCollection 2024 Nov.

Half body irradiation (HBI) for bone metastases in the modern radiotherapy technique era - A systematic review

Mateusz Bilski  1   2   3 , Katarzyna Konat-Bąska  4 , Federico Mastroleo  5   6 , Peter Hoskin  7   8 , Barbara Alicja Jereczek-Fossa  5   6 , Giulia Marvaso  5   6 , Mateusz Korga  1 , Jakub Klas  1 , Katarzyna Zych  1 , Piotr Bijak  1 , Andrzej Kukiełka  9   10 , Jacek Fijuth  11   12 , Łukasz Kuncman  11   12
Affiliations
Review

Half body irradiation (HBI) for bone metastases in the modern radiotherapy technique era - A systematic review

Mateusz Bilski et al. Clin Transl Radiat Oncol. .

Abstract

Bone metastases (BMs) are the most common cause of cancer-related pain and radiation therapy plays a key role in treating pain caused by it. The half-body irradiation (HBI) is a modality that can be used to treat patients with multiple painful BMs. In the modern era, concerns about toxicity and the availability of new agents requiring robust bone marrow function have limited the use of HBI in advanced cancer. Concerns about HBI toxicity stem from outdated techniques; modern methods like volumetric modulated arc therapy (VMAT) and helical tomotherapy now allow safer irradiation of complex target volumes. We conducted a systematic review to present updated information about HBI efficacy and potential toxicity. Pain relief usually occurs very quickly 2-3 weeks after HBI. The overall pain response rate was high in all the series, accounting for a median of 84 % (75.6-89 %), with a median of 36 % complete pain response. The toxicity is usually limited to G1/G2, with very rare G3 cases. More than 50 % of patients can reduce analgesic intake after HBI. Additionally, with modern radiotherapy techniques, quality of life is improved in most patients. HBI is a safe and effective method and should once again be reconsidered for more frequent use.

Keywords: 3D-CRT; Bone metastases; HBI; Half-body irradiation; Hemi-body irradiation; IMRT; Palliative radiotherapy; Tomotherapy; VMAT.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Peter Hoskin is supported by NIHR Manchester Biomedical Research Centre. The other authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) flow diagram for the literature selection process.
See this image and copyright information in PMC

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