91. Radiotherapy of Skeletal Metastases

  1. Clifford J. Rosen MD
  1. Edward Chow,
  2. Luluel M. Khan and
  3. Øyvind S. Bruland

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch91

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Chow, E., Khan, L. M. and Bruland, Ø. S. (2013) Radiotherapy of Skeletal Metastases, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch91

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • bone-seeking radiopharmaceuticals;
  • external beam radiotherapy (EBRT);
  • neuropathic pain;
  • pathological fracture;
  • skeletal metastases;
  • spinal cord compression (SCC)

Summary

Two-thirds to three-quarters of patients with advanced disease from breast and prostate carcinomas have skeletal metastases, and lung, thyroid, and renal carcinoma metastasize to bone in approximately 30% to 40% of cases. Additionally, clinical implications of skeletal metastases include pathological fracture, nerve entrapment and/or spinal cord compression (SCC), bone marrow insufficiency, and hypercalcaemia. Skeletal metastases are the single most frequent indication for palliative radiotherapy. External beam radiotherapy (EBRT) effectively relieves pain from localized sites of skeletal metastases. Treatment with intravenous (IV) injected bone-seeking radiopharmaceuticals (BSRs) is an intriguing alternative that selectively delivers ionizing radiation to targeted areas of amplified osteoblastic activity and targets multiple (symptomatic and asymptomatic) metastases simultaneously. The combination of radiotherapy or radionuclide therapy with bisphosphonates has recently been reviewed.