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Bisphosphonates and radiation therapy for palliation of metastatic bone disease

Hoskin, PJ; (2003) Bisphosphonates and radiation therapy for palliation of metastatic bone disease. Cancer Treatment Reviews , 29 (4) pp. 321-327.

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Abstract

Radiotherapy is an established treatment for metastatic bone pain. It may be delivered as a localised low dose treatment for localised bone pain or systemically for more widespread symptoms using hemibody external beam radiotherapy or intravenous bone-seeking radioisotopes. Bisphosphonates have been shown to reduce morbidity from bone metastases when given to patients with asymptomatic disease from myeloma and primary breast and prostate cancers. They also reduce metastatic bone pain in these sites. In the absence of randomised data comparing radiotherapy with bisphosphonates in the same clinical setting, comparison of the response rates from individual trials of the two modalities suggests that the overall pain response in all tumour types from radiotherapy is around 80% compared to a similar rate in myeloma with bisphosphonates but only 40% in solid tumours. Optimal use of the two modalities requires further investigation but since they have different dose limiting toxicities their incorporation in a combined modality approach to metastatic bone pain is rational using the concepts of additive effect and spatial co-operation in which bisphosphonates provide background control alongside acute pain relief using radiotherapy. They are also an important alternative for bone pain where radiation tolerance has been reached or radiotherapy is not readily available. (C) 2003 Elsevier Science Ltd. All rights reserved

Type: Article
Title: Bisphosphonates and radiation therapy for palliation of metastatic bone disease
Additional information: Journal English Review W B SAUNDERS CO LTD 0 AUG 716ZK LONDON Hoskin PJ Mt Vernon Hosp, Rickmansworth Rd, Northwood HA6 2RN, Middx, England CANCER TREATMENT REV 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND
Keywords: ABSENCE, As, bisphosphonates, bone, Bone disease, bone metastases, bone pain, Breast, BREAST-CANCER, cancer, cancers, clinical, CO, co-operation, comparison, control, CONTROLLED TRIAL, disease, DOUBLE- BLIND, English, EXTERNAL-BEAM RADIOTHERAPY, INTRAVENOUS, Low, Low dose, May, METASTASES, modality, MORBIDITIES, Morbidity, MULTIPLE-MYELOMA, myeloma, optimal, pain, PALLIATION, Patient, patients, PHASE-III, PLACEBO-CONTROLLED MULTICENTER, prostate, Prostate Cancer, PROSTATE-CANCER, radiation, Radiation therapy, Radiation Tolerance, RADIATION-THERAPY, Radioisotope, Radiotherapy, RANDOMIZED TRIAL, RATES, RD, response, Review, Science, Setting, SITE, SITES, SKELETAL MORBIDITY, SYMPTOM, SYMPTOMS, therapy, tolerance, toxicity, treatment, TRIAL, TRIALS, Tumour, tumours, Use
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/30418
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