Korean J Med.  2011 Sep;81(3):300-306.

Treatment of Bone Metastasis

• Cho EK

Abstract

The bone is a very common site of metastasis in patients with advanced cancer. Bone metastases can cause a wide range of symptoms and complications, such as pain, pathologic fractures, spinal cord compression, and hypercalcemia. The aim of treatment is to reduce the risk of skeletal related events, which in turn can increase quality of life and life expectancy. The main therapeutic alternatives directed at treating bone metastases in advanced cancer have been orthopedic stabilization, radiotherapy, bisphosphonates, and radioisotope treatment, in conjunction with chemotherapy or hormonal therapy. Drugs used for pain relief include non-opioid analgesics, opioid, and adjuvant analgesics. Most patients require a combination of medications for optimal pain relief. It has been demonstrated that single-fraction radiotherapy with 1 x 8 Gy is as effective for pain relief as multi-fraction regimens. Painful bone metastasis with pathologic fracture or spinal cord compression should be treated with multi-fraction long-course radiotherapy. Denosumab, a new generation of bone metastasis treatment, is a fully human monoclonal antibody that inhibits osteoclast maturation, activation, and function by binding to receptor activator of nuclear factor kappa B ligand, with the final result being a reduced rate of bone resorption.

Keyword

Bone; Metastasis; Opioid; Radiotherapy; Bisphosphonate

MeSH Terms

Analgesics
Analgesics, Opioid
Antibodies, Monoclonal, Humanized
Bone Resorption
Diphosphonates
Fractures, Spontaneous
Humans
Hypercalcemia
Life Expectancy
Neoplasm Metastasis
Orthopedics
Osteoclasts
Quality of Life
RANK Ligand
Spinal Cord Compression
Denosumab
Analgesics
Analgesics, Opioid
Antibodies, Monoclonal, Humanized
Diphosphonates
RANK Ligand