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A trial looking at radiotherapy or ibandronate for pain caused by prostate cancer that has spread to the bone (RIB trial)
This trial compared ibandronate with radiotherapy for pain caused by prostate cancer spread to the bone. This trial was supported by Cancer Research UK.
When this trial started the standard treatment for this type of pain was a single dose of radiotherapy to the affected part of the bone.
There is a group of drugs called bisphosphonates that can also help with bone pain. One of these is a drug called ibandronate. Some people in this trial had ibandronate, and some had radiotherapy.
The aim of the trial was to find out if ibandronate is as good as radiotherapy at relieving pain caused by secondary bone cancer.
Summary of results
The research team found that a single dose of bisphosphonates could be useful for treating pain caused by prostate cancer spread to the bone.
This trial recruited 470 men with prostate cancer that had spread to one area of bone. Half had a single dose of radiotherapy to the affected area. And half had a single dose of ibandronate through a drip into a vein.
Anyone who had no benefit from treatment could swap and have the other treatment. This is called a cross over study. About a third of men who had ibandronate went on to have radiotherapy. And about a quarter of men who had radiotherapy went on to have ibandronate.
The research team measured the men’s pain level by using a pain scale and recording the number and strength of painkillers they needed. They did this before treatment and then at 1, 2, 3, 6 and 12 months after treatment.
They found that the pain improved 1 month after treatment for
- 53% of those who’d had radiotherapy
- 49% of those who’d had ibandronate
And that pain had improved 3 months after treatment for
- 49% of those who’d had radiotherapy
- 56% of those who’d had ibandronate
There was no difference in pain level between the two groups at 6 months or 12 months after treatment.
The trial team concluded that there was little difference between the 2 groups, and that a single dose of ibandronate could be a useful treatment for pain caused by prostate cancer that has spread to the bone.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Prof Peter Hoskin
Cancer Research UK
NIHR Clinical Research Network: Cancer
University College London (UCL)
This is Cancer Research UK trial number CRUK/02/011.