Bone metastases from lung cancer: A paradigm for multidisciplinary onco-rheumatology management - 02/03/19
, Jean-Baptiste Pialat b, c, Aurélie Bellière d, Marie Brevet e, Chantal Decroisette f, Agnès Tescaru g, Julien Wegrzyn a, b, h, Cédric Barrey i, j, Françoise Mornex k, l, Pierre-Jean Souquet m, Nicolas Girard n, o| pagine | 10 |
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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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Bone metastases, Lung cancer, Denosumab, Zoledronic acid, Radiotherapy, Surgery, Fracture risk
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Vol 86 - N° 2
P. 185-194 - marzo 2019 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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