Role of radiation therapy and radiopharmaceuticals in bone metastases

Fairchild, Alysa; Chow, Edward

doi:10.1097/spc.0b013e3282efd70b

Cited by 10 publications

(6 citation statements)

References 21 publications

(21 reference statements)

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“…Additional analgesic techniques, such as radiotherapy (RT), are sometimes used. RT may be a cause of NP or may be used as a pain palliative [7,26,27]. The RT oncologist must, therefore, be able to identify NP vs. nociceptive pain and be knowledgeable about pain management to establish the most adequate treatment.…”

Section: Introductionmentioning

confidence: 99%

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

et al. 2011

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“…Bone metastasis, the most common cause of cancer-related pain, [1-3] occurs in up to 90% of patients with advanced breast or prostate cancer [1,2,4,5]. Median survival times for patients with breast and prostate cancer after diagnosis of bone metastasis range from 24 to 36 months [6-8].…”

Section: Introductionmentioning

confidence: 99%

Cost of palliative radiation to the bone for patients with bone metastases secondary to breast or prostate cancer

et al. 2012

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BackgroundTo estimate the costs (paid amounts) of palliative radiation episodes of care (REOCs) to the bone for patients with bone metastases secondary to breast or prostate cancer.MethodsClaims-linked medical records from patients at 98 cancer treatment centers in 16 US states were analyzed. Inclusion criteria included a primary neoplasm of breast or prostate cancer with a secondary neoplasm of bone metastases; ≥2 visits to ≥1 radiation center during the study period (1 July 2008 through 31 December 2009) on or after the metastatic cancer diagnosis date; radiation therapy to ≥1 bone site; and ≥1 complete REOC as evidenced by a >30-day gap pre- and post-radiation therapy.ResultsThe total number of REOCs was 220 for 207 breast cancer patients and 233 for 213 prostate cancer patients. In the main analysis (which excluded records with unpopulated costs) the median number of fractions per a REOC for treatment of metastases was 10. Mean total radiation costs (i.e., radiation direct cost + cost of radiation-related procedures and visits) per REOC were $7457 for patients with breast cancer and $7553 for patients with prostate cancer. Results were consistent in sensitivity analyses excluding patients with unpopulated costs.ConclusionsIn the US, current use of radiation therapy for bone metastases is relatively costly and the use of multi-fraction schedules remains prevalent.

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“…The main toxicity is flare reaction in 10% of patients and Grade 2 or less myelosuppression. 92 Whilst the evidence is more established in metastatic prostate cancer, there have been a few small relevant studies in metastatic breast cancer. 93 One study involving 100 patients (60 with metastatic prostate cancer, 40 with metastatic breast cancer) randomized to strontium or samarium shows improvement in Karnofsky status (+20) and reduction in pain by visual analog scale (−4), with more favorable results for osteoblastic than mixed metastases.…”

Section: Managing Bone Pain As An Established Skeletal Related Complimentioning

confidence: 99%

Optimal management of bone metastases in breast cancer patients

Wong

Pavlakis

2011

BCTT

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Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.

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Role of radiation therapy and radiopharmaceuticals in bone metastases

Cited by 10 publications

References 21 publications

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

Cost of palliative radiation to the bone for patients with bone metastases secondary to breast or prostate cancer

Optimal management of bone metastases in breast cancer patients

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