External beam radiation therapy (EBRT) for asymptomatic bone metastases in patients with solid tumors reduces the risk of skeletal-related events (SREs)

Bone metastases are common in cancer patients, affecting about 65–75% of patients with either breast cancer or prostate cancer and 30–40% of patients with lung cancer (1). External beam radiation therapy (EBRT) is often recommended when symptomatic bone metastases are identified (2). The most serious complications of bone metastases include pathological bone fractures and compression of the spinal cord or nerve roots due to vertebral collapse. These skeletal-related events (SREs) and the pain associated with bone metastases have devastating consequences for patient mobility, social functioning, and quality of life (3-5). SREs are also associated with a decrease in patient survival (2,6,7) and constitute a substantial financial burden. A single SRE was estimated, in 2004, to add $12,000 to the cost of treatment for a patient with lung cancer (8), a figure which had risen to $28,000 when the same estimate was made 5 years later (9)