Debate: Single-fraction treatment should be standard in the retreatment of uncomplicated bone metastases

Despite multiple randomized controlled trials (RCTs) and systematic reviews (1) that have shown equivalent pain control between single-fraction and multiple-fraction radiotherapy schedules for first treatment of painful bone metastases, there remains considerable use of multiple-fraction regimens (2) and much debate around this topic (3-6). Within this context, a new frontier has opened in the palliative radiotherapy realm: should single-fraction treatment be standard in the retreatment of uncomplicated bone metastases? We emphatically believe so. Evidence in support of this will be reviewed, and how this information can be applied to day-to-day practice in palliative radiation oncology will be discussed