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Modest renal impairment is common in the elderly population with prostatic carcinoma, but outflow obstruction at the vesico-ureteric junction or bladder neck should be treated appropriately before radionuclide administration. Recommended renal function parameters are: urea <12 mmol/L, creatinine <200 mmol/L. Risk of pathologic fracture and acute spinal cord compression should be regarded as a surgical or radiotherapy emergency and not be treated with radiopharmaceuticals. Urinary incontinence presents a contamination risk and should be managed by bladder catheterization before radiopharmaceutical administration.

25] BONE PAIN TRIAL WORKING PARTY, 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomized comparison with a multifraction schedule over 12 months of patient follow-up, Radiother Oncol 52 (1999) 111–121. , The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study, Radiother Oncol 52 (1999) 101–109. , Randomised trial of single dose versus fractionated palliative radiotherapy of bone metastases, Radiother Oncol 47 (1998) 233–240.

Three treatments were analysed: pain medication, chemotherapy, and single and multiple fraction radiotherapy. For each of the three models, costs and utilities were calculated separately. For pain medication, costs were calculated on morphine medication combined with a laxative. Higher doses were used along the model. 05 every 2 months afterwards. 111]. The radiotherapy regimens were chosen from the recent RTOG 97-14 trial which studied the palliative effect of a single fraction of 8 Gy vs. 6].

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