Conformal radiotherapy for vertebral bone metastasis

• Published in: Cancer radiothérapie 2016-10, Vol.20 (6-7), p.493-499
• Main Authors: Faivre, J C, Py, J F, Vogin, G, Martinage, G, Salleron, J, Royer, P, Grandgirard, N, Pasquier, D, Thureau, S
• Format: Article
• Language: fre
• Subjects: Back Pain - etiology; Back Pain - therapy; Cancer; Decompression, Surgical; Humans; Life Sciences; Organs at Risk; Patient Education as Topic; Quality of Life; Radiotherapy, Conformal; Radiotherapy, Image-Guided; Spinal Cord Compression - etiology; Spinal Cord Compression - radiotherapy; Spinal Cord Compression - surgery; Spinal Neoplasms - complications; Spinal Neoplasms - radiotherapy; Spinal Neoplasms - secondary
• ISSN: 1278-3218; 1769-6658
• DOI: 10.1016/j.canrad.2016.07.081

Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication. Analgesic re-irradiation is possible in the case of insufficient response or recurrent pain after radiotherapy. Metabolic radiation, bisphosphonates or denosumab do not dissuade external radiation therapy for pain relief. Systemic oncological treatments can be suspended with a period of wash out given the risk of radiosensitization or recall phenomenon. Better yet, the intensity modulated radiotherapy and stereotactic radiotherapy can be part of a curative strategy for oligometastatic patients and suggest new treatment prospects.