Clinical and radiological evaluation of patients with lytic, mixed and sclerotic bone metastases from solid tumors: is there a correlation between clinical status of patients and type of bone metastases?
OBJECTIVE
To investigate the association between the clinical status of patients with metastatic bone disease and the type of bone metastases.


METHODS
80 patients with skeletal metastases underwent both clinical and radiological assessments. Bone lesions were evaluated with computed tomography (CT), and patients were separated into three groups: lytic, mixed, sclerotic. Bone density of each lesion was measured in Hounsfield units (HU).


RESULTS
Patients with osteolytic lesions had the highest mean pain score with 8.1 +/- 2.2 points, the least mean scores for quality of life (QoL) and performance status (PS) with 31.4 +/- 14.6 and 58.6 +/- 9.7 points respectively, the highest percentage and mean opioid consumption (100% and 220.9 mg of oral daily morphine equivalent respectively), and the least mean bone density (116.3 +/- 40.4 HU). On the contrary, the group with sclerotic metastases had the least mean pain score with 4.6 +/- 1.3 points, the highest mean scores of QoL and PS (61.1 +/- 15.5 and 66.6 +/- 10 points respectively), the least percentage and mean opioid requirement (55.5% and 170.6 mg respectively), and the highest mean bone density (444 +/- 86.6 HU). The differences between the three groups were statistically significant for all parameters evaluated, apart from performance status between the sclerotic and mixed groups. The correlation coefficients were statistically significant between all parameters investigated. Bone density had a strong negative correlation with pain.


CONCLUSIONS
Our results show a clear correlation between the type of bone metastases and the clinical status of patients. Patients with excessive bone resorption suffer the most, and may be given priority in treatment. CT proved to be a practical and efficient method to investigate and classify metastatic bone lesions.
Vassiliou
Vassilios
V
Department of Radiation Oncology, University of Patras Medical School, Athinon 81, Patras 26441, Greece.
Kalogeropoulou
Christine
C
Petsas
Theodoros
T
Leotsinidis
Michael
M
Kardamakis
Dimitrios
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D015519:Bone Density; D001859:Bone Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D014057:Tomography, X-Ray Computed
D000701:Analgesics, Opioid