Bone metastases from lung cancer: a paradigm for multidisciplinary onco-rheumatology management

Publication date: Available online 6 April 2018 Source:Joint Bone Spine Author(s): Cyrille B. Confavreux, Jean-Baptiste Pialat, Aurélie Bellière, Marie Brevet, Chantal Decroisette, Agnès Tescaru, Julien Wegrzyn, Cédric Barrey, Françoise Mornex, Pierre-Jean Souquet, Nicolas Girard 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.
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research