[Concept and Overview of JSMO Guidelines for the Treatment of Bone Metastasis]

Many diagnostic and treatment modalities for bone metastasis are available. They include biomarker examination, imaging techniques, surgery, radiation therapy, chemotherapy, palliation, and rehabilitation, among others. Diagnosis of the disease and administration of these treatments require caregivers and other medical personnel including medical oncologists for primary tumors, radiologists, pathologists, orthopedists, radiotherapists, palliative care doctors, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, psychologists, and medical social workers. In multidisciplinary teamwork, knowledge of the potency of each intervention performed for the patients is important to improve treatment outcomes. Therefore, guidelines can contribute to better understanding and collaboration of one intervention with another. Guidelines should be based on medical evidences obtained from clinical studies that yield highly reliable results. Evidences for the treatment of bone metastasis are still lacking. Especially, the evidences for multi-modal treatment are rarely of described. In 2015, the Japanese Society for Medical Oncology released guidelines for the diagnosis and treatment of bone metastases. These guidelines aim to improve clinical procedures and treatment outcomes. In these guidelines, we described the current measures applicable for the treatment and care of patients with bone metastasis, the cost of which is covered by Japanese medical insurance. During the development of these guidelines, we recognized unsolved clinical questions in some parts of this field. Although the development of these guidelines is just a step toward improvement of treatment outcomes in patients with bone metastases, we hope that these guidelines are beneficial for such patients.