Please enable JavaScript.
Coggle requires JavaScript to display documents.
Palliative treatment (Bone metastases (Bone matastases according to…
Palliative treatment
Bone metastases
- Bone matastases according to primary site:
Breast > Prostate > Lung > Kidney > Rectum > stomach > colon > ovarian
- Localisation of bone metastases:
spine > pelvis > femur > skull > arm
- indications for palliative radiotherapy:
Pain, Risk of fracture, Post-surgical treatment after bone stabilization, Spinal cord compression
Pathogenesis of bone pain:
Direct tumor extension, Nerve compression / infiltration, Mediated by pro-inflammatory cytokines
Pathological fractures:
10% of bone metasatases,
Most common in femur and humerus
Most common in the following cancer types: Breast> Kidney> Lung
- Effects of palliative radiotherapy:
Pain control (days - weeks): Kill of pro-inflammatory cells (low RT dose sufficient)
Bone calcification (months): Kill of tumor cells
Most commonly used fractionation:
8 Gy/1fx./1 day, 20 Gy/5 fx./5 days, 30 Gy/10 fr./12 days
Examples
- treatment with radical intent:
Lung resection for lung cancer
Mastectomy or breast conserving treatment for breast cancer
Radiotherapy for cervival cancer
Chemotherapy for Hodgkin’s lymphoma
- symptomatic treatment:
Radiotherapy for painful bone metastases
Colostomy in advanced abominal cancer
Pharmacologic treatment of pain
Hormonal anabolic treatment of cancer- related cachexia
- treatment with palliative intent:
Radiotherapy of inoperable non-small-cell lung cancer
Chemotherapy or hormonal therapy of disseminated breast cancer
Hormonotherapy of disseminated prostate cancer
Resection of metastases to the brain or liver
Brachytherapy of non-small-cell lung cancer
Paliative radiotherapy
- Results in decreased tumor volume:
Decrease of symptoms related to tumor mass (e.g. spinal cord compression)
Bleeding control (e.g. hemoptysis)
Pain control
- Results in decreased inflamatory reactions
Indications
- Painful bone metastases
- Hemoptysis, pain and dyspnea in tumors of the chest
- Metastases to central nervous system
- Advanced head and neck cancer
- Advanced soft tissue and skin lesions
- Advanced pelvic tumors
- Cancer-related dysphagia
-
- Treatment aims in oncology:
Definitive (radical) = aims for cure
Palliative = aims for prolongation of life and symptom control
Symptomatic = aims for alleviation of cancer-related symptoms
- Cancer cure rates in European Union according to different cancer treatment modalities:
Surgery 22%
Radiotherapy 18%
Chemotherapy 5%