Treatment planning in patients with bone metastases. Final results of a prospective study using pre-medication with Fentanyl to improve irradiation reproducibility.

Background: To evaluate bone metastases patients’ compliance to radiation treatment planning, using transdermal fentanyl as pre-medication. Patients and Methods: Bone metastases patients with uncontrolled pain were enrolled. Fentanyl was delivered a week before the treatment simulation. Primary end point was the evaluation of the patients’ compliance to positioning set-up on the simulator’s couch. An evaluation of quality of life was secondary end point. Results: From March to December 2002 were enrolled 42 patients. During the treatment simulation 39/42 patients maintained the set-up position established by the physician. At the end of treatment, and 40 days after, both pain score and quality of life index ameliorated. Discussion: This study seems to demonstrate that an adequate pain control before simulation enhance the patients’ compliance to the treatment set-up.