A common question is how best to balance response and toxicity when palliating the unique radiobiology of multiple myeloma. This single institution experience looked at 204 sites palliated in 94 patients to determine a BED of at least 24 Gy (e.g. 20 Gy in 10 fractions) resulted in better pain control at the cost of slightly more mild toxicity when compared to lower BED regimens (e.g. 8 Gy in 1 fraction). Overall, almost everyone achieved pain relief and <10% required retreatment across a wide range of BED regimens. | Meredith, Adv Radiat Oncol 2023