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Nature Reviews. Disease Primers Oct 2020Bone is the most frequent site for metastasis for many cancers, notably for tumours originating in the breast and the prostate. Tumour cells can escape from the primary... (Review)
Review
Bone is the most frequent site for metastasis for many cancers, notably for tumours originating in the breast and the prostate. Tumour cells can escape from the primary tumour site and colonize the bone microenvironment. Within the bone, these disseminated tumour cells, as well as those arising in the context of multiple myeloma, may assume a state of dormancy, remaining quiescent for years before resuming proliferation and causing overt metastasis, which causes bone destruction via activation of osteoclast-mediated osteolysis. This structural damage can lead to considerable morbidity, including pain, fractures and impaired quality of life. Although treatment of bone metastases and myeloma bone disease is rarely curative, disease control is often possible for many years through the use of systemic anticancer treatments on a background of multidisciplinary supportive care. This care should include bone-targeted agents to inhibit tumour-associated osteolysis and prevent skeletal morbidity as well as use of appropriate local treatments such as radiation therapy, orthopaedic surgery and specialist palliative care to minimize the impact of metastatic bone disease on physical functioning. In this Primer, we provide an overview of the clinical features, the pathophysiology and the specific treatment approaches to prevent and treat bone metastases from solid tumours as well as myeloma bone disease.
Topics: Bone Neoplasms; Humans; Neoplasm Metastasis; Neoplasms
PubMed: 33060614
DOI: 10.1038/s41572-020-00216-3 -
Annals of Oncology : Official Journal... Oct 2010The successful treatment of patients with osteosarcoma requires close cooperation within an experienced multidisciplinary team including pediatric or medical... (Review)
Review
The successful treatment of patients with osteosarcoma requires close cooperation within an experienced multidisciplinary team including pediatric or medical oncologists, surgeons, pathologists and radiologists. Therefore, therapy should be performed in specialized centers able to provide access to the full spectrum of care. As in other rare malignancies, treatment should be administered within prospective multicenter trials. Therapy must include complete surgical removal of all detectable tumor sites as well as multiagent chemotherapy. The chemotherapy regimen should include several or all of the following four drugs: doxorubicin, high-dose methotrexate with leukovorin-rescue, cisplatin and ifosfamide. Preoperative (neoadjuvant) plus postoperative (adjuvant) polychemotherapy should be preferred, because it allows preparation for safe surgery and preparation of the appropriate prosthesis for the individual patient. The choice of the postponed definitive surgical procedure should be influenced by the anatomical site of the primary tumor, its relationship to neighboring structures, such as vessels and nerves, age and growth potential of the patient, and probably also by the response of the tumor to preoperative chemotherapy. A major, as yet unsolved, problem is the dismal prognosis for patients with unresectable or relapsed osteosarcomas. Novel approaches are needed in order to improve their prognosis.
Topics: Bone Neoplasms; Combined Modality Therapy; Humans; Neoplasm Metastasis; Neoplasm Staging; Osteosarcoma; Prognosis; Recurrence
PubMed: 20943636
DOI: 10.1093/annonc/mdq276 -
JAAPA : Official Journal of the... Aug 2018This article reviews the cause, clinical presentation, diagnostic methods, and management of osteosarcoma, the most common primary bone tumor and third most common... (Review)
Review
This article reviews the cause, clinical presentation, diagnostic methods, and management of osteosarcoma, the most common primary bone tumor and third most common cancer among children and adolescents. In the 1970s, the introduction of adjuvant chemotherapy following tumor resection improved overall 10-year survival from 30% to about 50% of patients. However, since that change in management strategy, the survival rate has since plateaued, with no improvement in overall 10-year survival since the 1990s. A better understanding of this disease is the first step to help improve these numbers.
Topics: Bone Neoplasms; Chemotherapy, Adjuvant; Humans; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Osteosarcoma
PubMed: 29979330
DOI: 10.1097/01.JAA.0000541477.24116.8d -
Nature Reviews. Disease Primers Oct 2020
Topics: Bone Neoplasms; Humans; Neoplasm Metastasis; Neoplasms
PubMed: 33060570
DOI: 10.1038/s41572-020-00226-1 -
Journal of the National Comprehensive... Jun 2013Primary bone cancers are extremely rare neoplasms, accounting for fewer than 0.2% of all cancers. The evaluation and treatment of patients with bone cancers requires a...
Primary bone cancers are extremely rare neoplasms, accounting for fewer than 0.2% of all cancers. The evaluation and treatment of patients with bone cancers requires a multidisciplinary team of physicians, including musculoskeletal, medical, and radiation oncologists, and surgeons and radiologists with demonstrated expertise in the management of these tumors. Long-term surveillance and follow-up are necessary for the management of treatment late effects related to surgery, radiation therapy, and chemotherapy. These guidelines discuss the management of chordoma, giant cell tumor of the bone, and osteosarcoma.
Topics: Bone Neoplasms; Humans; Neoplasm Staging
PubMed: 23744868
DOI: 10.6004/jnccn.2013.0088 -
Journal of Medical Imaging and... Dec 2023In the last few decades, interventional radiology (IR) has significantly increased its role in the management of bone tumours including bone metastases (BM) that... (Review)
Review
In the last few decades, interventional radiology (IR) has significantly increased its role in the management of bone tumours including bone metastases (BM) that represent the most common type of tumour involving the bone. The current IR management of BM is based on the 'palliative-curative' paradigm and relies on the use of consolidative (i.e. osteplasty, osteosynthesis) and/or ablation (i.e. cryoablation, radiofrequency ablation, electrochemotherapy) techniques. The present narrative review will overview the current role of IR for the management of BM.
Topics: Humans; Bone Neoplasms; Radiofrequency Ablation; Cryosurgery
PubMed: 37742284
DOI: 10.1111/1754-9485.13587 -
Instructional Course Lectures 2008Malignant bone tumors represent a small percentage of cancers nationwide and also are much less common than malignant soft-tissue tumors. The rarity of the condition... (Review)
Review
Malignant bone tumors represent a small percentage of cancers nationwide and also are much less common than malignant soft-tissue tumors. The rarity of the condition makes it imperative that orthopaedic surgeons in nononcologic practices are able to recognize the symptoms that suggest a possible bony malignancy to avoid inappropriate or delayed treatment. The most common primary malignant bone tumors, osteosarcoma and Ewing's sarcoma, occur in childhood. Chondrosarcoma occurs more frequently in older adults. Rare tumors such as chordoma and adamantinoma have anatomic predilections for the sacrum and tibia, respectively. The primary symptom of a patient with a malignant bone tumor is pain, which often occurs at rest or at night. There are also characteristic findings on physical examination such as swelling or decreased joint range of motion. Patients with a likely malignancy require thorough staging to determine the extent of disease and a well-planned biopsy for accurate diagnosis. The biopsy can be an image-guided needle biopsy or an open incisional biopsy. Knowledge of specific tumor characteristics and treatment options for osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, chordoma, and adamantinoma is important. Patients with osteosarcoma and resectable Ewing's sarcoma are treated with chemotherapy followed by surgical resection. Secondary sarcomas can occur in previously benign bone lesions and require aggressive treatment. Specific techniques are available for the resection of malignant bone tumors from the upper extremities, lower extremities, pelvis, and spine. Reconstruction options include the use of allografts, megaprostheses, and vascularized autografts. There has been a trend toward more prosthetic reconstructions because of early complications with allografts. The care of patients with primary malignant bone tumors requires a multidisciplinary approach to treatment. The orthopaedic oncologist is a vital member of a team composed of musculoskeletal radiologists and pathologists, radiation oncologists, medical and pediatric oncologists, and microvascular surgeons.
Topics: Bone Neoplasms; Global Health; Humans; Morbidity; Neoplasm Staging; Orthopedic Procedures; Prognosis
PubMed: 18399615
DOI: No ID Found -
Surgical Oncology Clinics of North... Apr 2011Metastatic disease is the most common neoplasm involving the skeletal system and can result in significant pain and morbidity. Although narcotic medications and external... (Review)
Review
Metastatic disease is the most common neoplasm involving the skeletal system and can result in significant pain and morbidity. Although narcotic medications and external beam radiation therapy remain the standard of care, several image-guided ablation techniques have evolved to play a role in the management of painful bone metastases. This article reviews the percutaneous ablation techniques available for relieving bone pain in patients suffering from cancer.
Topics: Ablation Techniques; Bone Neoplasms; Humans
PubMed: 21377588
DOI: 10.1016/j.soc.2010.11.006 -
The International Journal of... Mar 2018Breast cancer is the most common cancer affecting women worldwide, with bone metastases presenting as the most common site of disease recurrence. Bone metastases... (Review)
Review
Breast cancer is the most common cancer affecting women worldwide, with bone metastases presenting as the most common site of disease recurrence. Bone metastases secondary to breast cancer negatively impacts patient survival, mobility, and quality of life. Furthermore, the clinical complications of breast cancer bone metastases are associated with significant financial burden to the individual and society. The molecular mechanisms involved in the metastasis, colonisation, and proliferation of breast cancer cells in bone are complex and involve crosstalk between breast cancer cells and the bone microenvironment. The ability of metastatic breast cancer cells to hijack normal biological processes involved in bone remodelling is a key driver of osteolytic and osteoblastic bone lesions. As such, our understanding of how breast cancer cells manipulate normal bone remodelling pathways is essential for the development of new therapeutic agents to improve patient outcomes. In this review, we discuss bone remodelling under normal physiological conditions and explore key pathways dysregulated in breast cancer metastasis to bone. We provide an overview of systemic therapies currently recommended for the treatment of breast cancer bone metastases and highlight emerging therapeutic targets.
Topics: Bone Neoplasms; Bone Remodeling; Breast Neoplasms; Female; Humans; Neoplasm Metastasis
PubMed: 29309917
DOI: 10.1016/j.biocel.2018.01.003 -
Annals of Palliative Medicine Apr 2019Multiple new options are available in the palliation of bone metastases. Most of these techniques can be used in conjunction with radiation therapy either before or... (Review)
Review
Multiple new options are available in the palliation of bone metastases. Most of these techniques can be used in conjunction with radiation therapy either before or after and are now giving patients who have reached dose limitations new options. These techniques can also be used with vertebroplasty (VP) to increase structural stability post tumor ablation. Localized percutaneous treatment in the bone such as thermal [radiofrequency ablation (RFA)] and light [photodynamic therapy (PDT)] have been used to destroy tumor prior to injection with cement. This educational review will discuss the safety profile, technique and indications for emerging technology in the area of locoregional treatment of bone metastases in conjunction with vertebral augmentation. It will not delve comprehensively into conventional lines of treatment where indications and outcomes have already been well established.
Topics: Bone Neoplasms; Combined Modality Therapy; Humans; Lumbar Vertebrae; Neoplasm Metastasis; Palliative Care; Radiofrequency Ablation; Spinal Neoplasms; Vertebroplasty
PubMed: 30691279
DOI: 10.21037/apm.2018.12.04