Radiotherapy of bone metastases: 2025 update.

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Bone metastases are a common complication in cancer patients.
• Radiotherapy is a cornerstone in managing bone metastases, offering pain relief and preventing complications.
• Existing guidelines require updates to reflect advancements in radiotherapy techniques and understanding of toxicity.

Purpose of the Study:

• To provide updated recommendations for the Société française de radiothérapie oncologique (French Society for Radiation Oncology) on bone metastases radiotherapy.
• To outline indications and technical aspects for both standard and advanced radiotherapy techniques.
• To emphasize safety considerations, particularly spinal cord toxicity.

Main Methods:

• Consensus-based recommendations developed by the Société française de radiothérapie oncologique.
• Review of current evidence and clinical practice for radiotherapy in bone metastases.
• Inclusion of indications for palliative, adjuvant, and re-irradiation scenarios.

Main Results:

• Standard radiotherapy techniques are effective for pain palliation and managing spinal cord compression.
• Stereotactic radiotherapy is a viable option for painful bone metastases, oligometastatic disease, and re-irradiation.
• Close monitoring for spinal cord toxicity is crucial, especially with advanced techniques.

Conclusions:

• The updated guidelines provide a framework for optimal radiotherapy use in bone metastases.
• Balancing efficacy with toxicity is paramount, necessitating careful patient selection and technique choice.
• These recommendations aim to improve patient outcomes and quality of life in cancer care.