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[Conformal radiotherapy for vertebral bone metastasis].

J C Faivre1, J F Py1, G Vogin1

  • 1Département universitaire de radiothérapie - curiethérapie, institut de cancérologie de Lorraine, Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|September 12, 2016
PubMed
Summary

External beam radiation therapy offers pain relief for bone metastases and fracture prevention. Advanced techniques like intensity-modulated and stereotactic radiotherapy present new curative options for select patients.

Keywords:
Bone metastasisConformalDouleurIntensity-modulatedMétastase osseusePainRadiotherapyRadiothérapieSoins oncologiques de supportsSpineSupportive careVertèbre

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Palliative Care

Background:

  • External beam radiation therapy (EBRT) is a cornerstone in managing painful bone metastases and preventing skeletal-related events.
  • It plays a crucial role post-operatively for fracture stabilization and after procedures like vertebroplasty/kyphoplasty.
  • Spinal cord compression is a critical oncologic emergency necessitating prompt radiotherapy, often post-operatively.

Purpose of the Study:

  • To outline the established and evolving roles of radiation therapy in managing bone metastases.
  • To discuss the integration of EBRT with surgical interventions and systemic therapies.
  • To highlight advanced radiotherapy techniques for potential curative applications.

Main Methods:

  • Review of current standards of care and emerging strategies in radiation oncology for bone metastases.
  • Discussion of indications for EBRT, including palliative, prophylactic, and emergency scenarios.
  • Exploration of concurrent and sequential treatment paradigms with surgery and systemic agents.

Main Results:

  • EBRT is effective for pain relief and fracture prevention in bone metastases.
  • Radiotherapy is mandatory post-vertebroplasty/kyphoplasty and indicated for spinal cord compression.
  • Re-irradiation is feasible for persistent or recurrent pain.
  • Systemic therapies may require a washout period due to radiosensitization risks.
  • Advanced techniques (IMRT, stereotactic radiotherapy) offer curative potential for oligometastatic disease.

Conclusions:

  • External beam radiation therapy remains vital for symptomatic bone metastases and skeletal complication prevention.
  • Integration with surgery and careful consideration of systemic treatments are key.
  • Advanced radiotherapy techniques are expanding treatment possibilities, including curative intent for specific patient groups.