Emily Keit, Daniel E Oliver, Hsiang-Hsuan M Yu, Peter A S Johnstone
{"title":"Simplifying post-operative radiotherapy for bone metastases.","authors":"Emily Keit, Daniel E Oliver, Hsiang-Hsuan M Yu, Peter A S Johnstone","doi":"10.21037/apm-24-168","DOIUrl":null,"url":null,"abstract":"<p><p>The delivery of post-operative radiotherapy (PORT) for solid tumor bone metastases is a well-established practice that aims to enhance patient outcomes following surgical intervention. Surgery for osseous metastases serves to stabilize bone, alleviate pain, reduce tumor volume, and relieve pressure on critical neurological components. Radiotherapy complements surgery by addressing residual malignant disease and cancer-induced pain. Together, they serve to improve local control, maximize functional outcomes, control pain, and improve patients' overall quality of life. Despite the prevalence of non-spine bone metastases (NSBMs) necessitating operative intervention, structured guidelines for palliative PORT are limited. This is, in part, due to a paucity of research specific to this topic. As such, a wide array of doses are deemed acceptable, leading to varied practice patterns. Conversely, there is more extensive literature available, including prospective trials, for the management of post-operative spine bone metastases (SBMs). This includes advances such as stereotactic body radiotherapy (SBRT), separation surgery, and the utilization of simultaneous integrated boosts that enable evidence driven, safe dose escalation. This mini-review aims to provide a summary of the existing literature on palliative postoperative radiotherapy for both NSBMs and SBMs. By offering historical context and summarizing current evidence, this article seeks to aid clinical decision-making and highlight areas for future research to enhance treatment standardization and patient care.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 2","pages":"189-195"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of palliative medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/apm-24-168","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}
引用次数: 0
Abstract
The delivery of post-operative radiotherapy (PORT) for solid tumor bone metastases is a well-established practice that aims to enhance patient outcomes following surgical intervention. Surgery for osseous metastases serves to stabilize bone, alleviate pain, reduce tumor volume, and relieve pressure on critical neurological components. Radiotherapy complements surgery by addressing residual malignant disease and cancer-induced pain. Together, they serve to improve local control, maximize functional outcomes, control pain, and improve patients' overall quality of life. Despite the prevalence of non-spine bone metastases (NSBMs) necessitating operative intervention, structured guidelines for palliative PORT are limited. This is, in part, due to a paucity of research specific to this topic. As such, a wide array of doses are deemed acceptable, leading to varied practice patterns. Conversely, there is more extensive literature available, including prospective trials, for the management of post-operative spine bone metastases (SBMs). This includes advances such as stereotactic body radiotherapy (SBRT), separation surgery, and the utilization of simultaneous integrated boosts that enable evidence driven, safe dose escalation. This mini-review aims to provide a summary of the existing literature on palliative postoperative radiotherapy for both NSBMs and SBMs. By offering historical context and summarizing current evidence, this article seeks to aid clinical decision-making and highlight areas for future research to enhance treatment standardization and patient care.
期刊介绍:
Annals of Palliative Medicine (Ann Palliat Med; Print ISSN 2224-5820; Online ISSN 2224-5839) is an open access, international, peer-reviewed journal published quarterly with both online and printed copies since 2012. The aim of the journal is to provide up-to-date and cutting-edge information and professional support for health care providers in palliative medicine disciplines to improve the quality of life for patients and their families and caregivers.