A secondary analysis of a randomized trial designed to assess the utility of dex in reducing pain flare with 8 Gy x 1 for bone mets (spoiler: it did) was reported this month in JAMA Onc and showed a significant improvement in quality of life (QOL) among responders to the single-fraction regimen. At only 10 days out from treatment, over 40% of patients experienced significant reductions in pain which translated into improvements in functional and psychosocial endpoints. QOL endpoints in physical, emotional and global domains were also significantly improved in responders at 7 weeks. There is a lot of talk these days about avoiding aggressive care at the end of life, and for good reason. But with a single-day treatment achieving improved pain and other QOL metrics as quickly as 10 days, 8 Gy x 1 remains strongly in the palliative care camp. And it appears beneficial even for patients with limited life expectancies. Now that’s a wise choice.