Modern Palliative Treatments for Metastatic Bone Disease

Abstract

Currently, modern treatments are available for the palliative management of patients with metastatic bone disease. These include modern radiation therapy, chemotherapy, embolization, electrochemotherapy, radiofrequency ablation, and high-intensity focused ultrasound. As such it is of interest for all physicians with no experience with these developments to make palliative procedures safer and more reliable.

Primary surgery versus no surgery in synchronous metastatic breast cancer: Patient-reported Quality-of-Life outcomes of the prospective randomized multicenter ABCSG-28 Posytive Trial

“…Interestingly, patients with only bone metastases reported worse physical and role functioning and pain compared to patients with visceral metastases. Pain is a leading symptom in patients with bone metastases, and an important factor influencing QoL [31].…”

MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics

“…It has been anticipated that in the future, it will be technically possible to treat metastases in the entire vertebral column. 85 Consensus has been reached that FUS is an acceptable secondary treatment option for patients who have painful bone metastases in a non-spinal site, for whom radiotherapy has not been effective. FUS can be considered as a primary palliative treatment option in patients for whom radiotherapy may be contraindicated (e.g.…”

“…Spinal metastases cannot be faced at the moment because of concerns about thermal damage to the spinal cord, and for technical and accessibility challenges. 85 Since approximately one-third of patients with painful bone metastases have lesions in the thoracic or lumbar spine, efforts on significant engineering development are being directed to accomplish this goal. It has been anticipated that in the future, it will be technically possible to treat metastases in the entire vertebral column.…”

Thyroid cancer-related bone metastases: increasingly good prospects for treatment

“…On the other hand, SREs occurring in patients with thyroid cancer complicated by bone metastases still constitute a poor prognostic indicator, also by comparison with patients suffering from other distant metastases [4]. Currently, a number of modern therapeutic modalities, such as embolization, radiofrequency ablation, or high-intensity focused ultrasound, can be applied as palliative treatment of BM, though the efficacy and safety of the procedure should be carefully weighed up in the interest of providing optimal treatment [5]. Selective embolization with N-butyl cyanoacrylate for BM from different primary tumors was performed in 243 patients with 309 embolizations [5].…”

“…Currently, a number of modern therapeutic modalities, such as embolization, radiofrequency ablation, or high-intensity focused ultrasound, can be applied as palliative treatment of BM, though the efficacy and safety of the procedure should be carefully weighed up in the interest of providing optimal treatment [5]. Selective embolization with N-butyl cyanoacrylate for BM from different primary tumors was performed in 243 patients with 309 embolizations [5]. A complete occlusion of metastatic blood supply and more than 80% devascularization of the lesions were observed in all the lesions, accompanied, however, by considerable side effects in 37% of the patients [6].…”