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Prophylactic dexamethasone for the prevention of radiation-induced pain flare in patients with bone metastases: a meta-analysis.

Created on 29 Aug 2026

Authors

Lang Chen, YaJun Wang, Jian Tan, MingLiu He, Han Gou, Xing Chen, YiHui Liu

Published in

Frontiers in oncology. Volume 16. Pages 1894776. Epub Aug 14, 2026.

Abstract

This study primarily evaluated the efficacy and safety of prophylactic dexamethasone in preventing radiation-induced pain flare in patients with bone metastases undergoing palliative radiotherapy.
A systematic search of the PubMed, Embase, and Cochrane databases was conducted to identify prospective randomized controlled trials published up to May 2026. After screening, six studies were ultimately included. A random-effects model was used for pooled analyses, and sensitivity analyses were performed to assess heterogeneity.
A total of 1,833 records were initially identified, and six prospective randomized controlled trials were ultimately included in the final analysis. Pooled analysis demonstrated that prophylactic dexamethasone was associated with a significantly lower risk of radiation-induced pain flare compared with placebo (RR = 0.63, 95% CI: 0.46-0.86). Sensitivity analyses did not identify a clear source of heterogeneity within the dexamethasone group. Adverse events were infrequently reported and were generally mild, with no severe treatment-related complications observed in the included studies.
Prophylactic dexamethasone may reduce the incidence of radiation-induced pain flare in patients with bone metastases undergoing palliative radiotherapy. However, given the limited number of studies and heterogeneity among treatment protocols, these findings should be interpreted cautiously, and further large-scale randomized controlled trials are warranted.

PMID:
42666176
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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