Bone metastases from lung cancer: A paradigm for multidisciplinary onco-rheumatology management - 21/07/18
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Highlights |
• | Bone metastasis biopsy may provide histology and molecular diagnosis in some cases. |
• | Each location of bone metastasis should be evaluated on three different aspects: pain, neurological risk and fracture risk. |
• | Bone metastases require a dedicated management in harmony with the oncological strategy. |
• | Bone metastasis management is transversal and relies on bone metastatic multidisciplinary tumour board (BM2TB). |
• | Bone metastasis management includes systemic and local treatments. |
Abstract |
Bone is the third metastatic site after liver and lungs. Bone metastases occur in one out of three lung cancers and are usually of osteolytic aspect. Osteolytic bone metastases are responsible of long bone and vertebral fractures leading to restricted mobility, surgery and medullar compression that severely alter quality of life and that have a huge medico-economic impact. In the recent years, Bone Metastatic Multidisciplinary Tumour Board (BM2TB) have been developed to optimize bone metastases management for each patient in harmony with oncology program. In this review, we will go through all the different aspects of bone metastases management including diagnosis and evaluation (CT scan, Tc 99m-MDP bone scan, 18FDG-PET scan and biopsy for molecular diagnosis), systemic bone treatments (zoledronic acid and denosumab) and local treatments (interventional radiology and radiotherapy). Surgical strategies will be discussed elsewhere. Based on the last 2017-Lung Cancer South East French Guidelines, we present a practical decision tree to help the physicians for decision making in order to reach a personalized locomotor strategy for every patient.
Le texte complet de cet article est disponible en PDF.Keywords : Bone metastases, Lung cancer, Denosumab, Zoledronic acid, Radiotherapy, Surgery, Fracture risk
Plan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?