Half body irradiation (HBI) in palliative treatment of multiple cancer metastases - contemporary evaluation

The aim of this review is to evaluate the efficacy of HBI as a method of palliative treatment of multiple cancer metastases and compare it with other alternate methods of radiotherapy. The sources of the analysis are articles available in Medline base.
HBI is an efficient and safe method of palliative treatment which has the potential to improve completely or partially pain response. The overall response rate of HBI was 67-94% with a 20-73% complete response rate. The pain decrease is observed in 25-70% patients during the first 24-48 hours after HBI, and had been performed in 7-day time in 80% patients. HBI is applied as one-single dose (SD) or fractionation scheme (F-HBI).
The fractionation HBI gives a chance to apply higher total dose while a decrease in the risk of adverse effects. However, one-single dose HBI recquires shorter hospitalization and enchances earlier positive palliative effects.
Other form of HBI therapy is combination of HBI and local radiotherapy (LFI) which increases efficacy of these treatments alone. Such combination allows to decrease the risk of pain progression and the pain free survival is longer.
Some studies comparing efficacy of HBI with therapies providing additional factors that had been expected to improve efficacy of radiotherapy (misonidasole, nicotinamide), or decreased complications (G-CSF, GM-CSF) were also considered in this review. However, they do not directly indicate the prevail of such combinations over HBI alone and in consequence they should undergo further clinical trials.
In a majority of the patients the tolerance of HBI is good. Some mild complications (nausea, vomiting) might be effectively eliminated by premedication. The most serious are bone marrow complications.
HBI is an efficient therapeutic tool of multiple bone metastases and allows to prevent progress of bone metastases, reduces number of cancer focuses and improves the quality of life.