This review will include discussion of the role of radiation therapy for osseous metastases and metastatic spinal cord compression, as well as the use of radiopharmaceuticals for painful osseous metastases.
In order to achieve maximum survival of patients with metastatic castration-resistant prostate cancer, the judicious use of all available effective agents and modalities is required. Both EBRT and radium-223 are effective at relieving pain, but both may decrease bone marrow function.
There is no question that radiopharmaceuticals have a role in the management of patients with metastatic bone disease. There is also no question that fractionated external beam radiotherapy (EBRT) is highly effective and generally well tolerated when delivered with large open or focal fields.
The anti-RANKL antibody denosumab is more effective for preventing bone metastasis in men with high-risk castration-resistant prostate cancer compared with low-risk disease, according to results of a new study.
A pair of studies from the ASCO annual meeting examined bone metastases from lung cancer, with one study finding that survival in patients was poorer in patients with bone metastases, and another study finding that the development of bone metastases could predict subsequent development of metastasis in the brain.
Bone metastases result in poorer outcomes for those patients with advanced renal cell carcinoma (RCC), who were treated with a molecularly targeted therapy. The results were presented in two separate analyses at the annual ASCO meeting.