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Bone Metastasis

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International Manual of Oncology Practice

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Abstract

Bone is a common site of distant involvement in advanced cancers. About 70% of patients with advanced breast and prostate cancers and up to 30–40% of patients with advanced lung, thyroid and kidney cancers develop metastatic bone disease.

Cancer-bone cell interactions are complex and can lead to altered bone metabolism and increased bone fragility. Metastatic bone disease is associated with significant morbidity and can have a substantial survival impact. Typically, skeletal complications of bone metastasis include pathological fracture, spinal cord compression, the need for surgery or radiotherapy for a symptomatic bone metastases, and hypercalcemia, collectively referred as skeletal-related events (SREs).

The treatment landscape of bone metastasis is multimodal and has evolved over the last decade. It includes both medical, radiation and surgical management.

In this chapter we will review the epidemiology, pathophysiology, clinical evaluation and management of metastatic bone disease from solid tumors.

The authors would like to thank Irene Ferreira for the invaluable help in the development of Fig. 49.1 and Sandra Casimiro for the insightful comments during the discussion of the chapter.

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Abbreviations

ALP:

Alkaline phosphatase

BMPs:

Bone morphogenetic proteins

BP:

Bisphosphonate

BS:

Bone scintigraphy

BTA:

Bone-targeted agents

CRT:

Convential radiotherapy

CT:

Computerized tomography

CXCL12:

C-X-C motif chemokine 12

CXCR4:

C-X-C chemokine receptor type 4

CXCR7:

C-X-C chemokine receptor type 7

IGF:

Insulin like growth factor

IL:

Interleukin

ISUP:

International Society of Urological Pathology

IV:

Intravenous

LHRH:

Luteinizing hormone releasing hormone

MRI:

Magnetic resonance imaging

NTX:

N-terminal cross-linked telopeptide of type I collagen

PET:

Positron emission tomography

PO:

Per Os

PTHrp:

Parathyroid hormone-related peptide

RANKL:

Receptor activator of nuclear factor κ B ligand

RT:

Radiotherapy

SBRT:

Stereotactic Body Radiotherapy

SC:

Subcutaneous

SRE:

Skeletal related event

TGF- β:

Transforming growth factor-β

TNF-α:

Tumor necrosis factor α

XR:

Plain radiograph

ZA:

Zoledronic acid

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Authors and Affiliations

  1. Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal

    Arlindo R. Ferreira, André N. Abrunhosa-Branquinho, Marília Jorge & Luís Costa

  2. Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

    Arlindo R. Ferreira & Luís Costa

Authors
  1. Arlindo R. Ferreira
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  2. André N. Abrunhosa-Branquinho
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  3. Marília Jorge
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  4. Luís Costa
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Corresponding author

Correspondence to Arlindo R. Ferreira .

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Editors and Affiliations

  1. Division of Medical Oncology, Federal University of São Paulo (UNIFESP) & Hospital Israelita Albert Einstein, São Paulo, Brazil, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal

    Ramon Andrade De Mello

  2. Oncology Department, Henry Dunant Hospital Center, Athens, Greece

    Giannis Mountzios

  3. Department of Biomedical Sciences and Medicine, Universidade do Algarve, Faro, Portugal

    Álvaro A. Tavares

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Ferreira, A.R., Abrunhosa-Branquinho, A.N., Jorge, M., Costa, L. (2019). Bone Metastasis. In: De Mello, R., Mountzios, G., Tavares, Á. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16245-0_49

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