Approximately 70% of people with advanced breast and prostate cancer develop secondary bone cancer (metastases).
This disease weakens the bone, causing 'pathological' fractures which then require surgery to stabilise or replace the affected bone. Pathological fractures occur when bone breaks without any causative injury and they can be incredibly painful.
Consultants at The Royal Orthopaedic Hospital NHS Foundation Trust are at the forefront of research into whether intervening with radiotherapy immediately following surgery to treat pathological fractures reduces pain significantly, compared to no intervention. This is being undertaken as part of the PORTRAIT trial (Post Operative Radiotherapy in Surgically Treated Bone Metastases), a multi-centre study funded by the National Institute for Health and Care Research (NIHR). The PORTRAIT trial is sponsored by the Royal Orthopaedic Hospital and is led by Chief Investigator Mr Jonathan Stevenson, Orthopaedic Oncology Consultant.
Mr Stevenson comments: “Following surgery for pathological fractures, patients usually receive radiotherapy. Despite its widespread use, there is no high-quality evidence that having radiotherapy after surgery improves pain, quality of life, or reduces the risk of needing another operation. Because radiotherapy has side-effects, as well as requiring additional hospital visits and scans, it is essential to understand if any benefits justify additional harms and cost.”
“This is the first time the Royal Orthopaedic Hospital will lead sponsor a clinical trial and we’re incredibly proud for the UK to be leading on this essential research. Metastatic bone disease is becoming more prevalent and so it’s imperative we have clear guidelines to best support our patients.”
£2.2m of funding from the NIHR will enable the study to recruit 20 sites across the UK in a randomised trial which seeks to recruit 350 patients over the age of 18.
The Royal Orthopaedic Hospital is a leading centre for orthopaedic oncology globally, specialising in the diagnosis and treatment of bone and soft tissue tumours. It also plays a key role in research into and treatment of metastatic bone disease, including the development of new BOAST guidelines for the management of metastatic bone disease.
Professor Anthony Gordon, Programme Director for the NIHR Health Technology Assessment (HTA) Programme, which is funding the trial, said: "The PORTRAIT trial will help researchers understand whether radiotherapy after surgery is beneficial for patients or not. Studies like this show the importance in investing in clinical research in the NHS to ensure that people have access to the best and most suitable treatments."
The trial team is seeking new centres to join - please email
For further detail on the clinical trial visit Portrait - Health Sciences, University of York
