Palliative radiotherapy for bone metastases from lung cancer: Evidence-based medicine?

Table 5 Factors influencing choice of dose fractionation scheme based on direct questioning of respondents

Case	Most impact	Least impact
Uncomplicated-spine
Nakamura Case 2 (Japan, 2012)	Factors influencing those who chose MF: Time until first increase in pain Incidence of spinal cord compression Incidence of pathologic fracture	NR
De Bari Case 21 (Italy, 2011)	Prognosis Performance status Radiologic appearance of lesions	Financial aspects Personal habits Waiting list
Roos Case 32 (Aust/NZ, 2000)	Factors influencing those who chose SF: Literature results Patient convenience Resource limitations Factors influencing those who chose MF: Minimize chance of recurrent pain Minimize risk of neurologic progression (tie) Optimize tumour regression Patient convenience	NR
Complicated-neuropathic pain
Roos Case 42 (Aust/NZ, 2000)	Factors influencing those who chose SF: Literature results Patient convenience Resource limitations Factors influencing those who chose MF: Minimize risk of neurologic progression Minimize chance of recurrent pain Optimize tumour regression	NR
Complicated – impending spinal cord compression and impending pathologic fracture
De Bari Case 41 (Italy, 2011)	Radiologic appearance of lesions Site of metastasis Prognosis	Financial aspects Personal habits (tie) Waiting list
Overall
Fairchild (Intl, 2009)	Prognosis Risk of spinal cord compression Performance status Previous RT Published evidence	Departmental policy Waiting list Future retreatment Age Late toxicity

¹Literature results were not one of the prespecified options;

²Includes specialist and trainee responses. Intl: International; MF: Multiple fractions; NR: Not reported; SF: Single fractions.