title: [The management of bone metastasis].
abstract: Bone metastasis are the most common cause of pain related to cancer, reducing patients' quality of life, and sometimes threatening their life-expectancy. Their management has to be pluridisciplinary, because of all the therapeutic options and the diversity of bone metastasis locations. The aim of this work is to propose a rational decisional algorithm for the treatment strategy of these secondary locations. Anti-resorbtive drugs with systemic action, surgery, conventional or stereotactic radiation therapy, and new techniques of interventional radiology are options that could be used separately or combined. They have shown benefits on symptomatic treatment, improving quality of life. Their indications vary according to the tumor site (short vs. long bones, carrier vs. non-carrier bones), the symptomatology (pain, neurologic symptoms), and the presence of complications (most of all fractures). The diverse presentations lead us to define this decisional algorithm, to guide the practice, while giving the maximal benefit to each patient according to each metastasis.
authors.affiliation: Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, service d'oncologie multidisciplinaire et innovations thérapeutiques, 13920 Marseille cedex 15, France. Electronic address: remi.bonetto1@gmail.com.
authors.forename: Rémi
authors.initials: R
authors.lastname: Bonetto
authors.affiliation: Institut Paoli-Calmettes, département d'oncologie-radiothérapie, 232, boulevard Sainte-Marguerite, 13273 Marseille cedex 09, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Tallet
authors.affiliation: Aix-Marseille université, hôpital Nord, service de neurochirurgie, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Mélot
authors.affiliation: Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, CHU La Timone, service de radiothérapie, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Calderon
authors.affiliation: Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, service d'oncologie multidisciplinaire et innovations thérapeutiques, 13920 Marseille cedex 15, France; Aix-Marseille université, faculté de médecine, centre de recherche en oncologie biologique et oncopharmacologie, Inserm U911, 13005 Marseille, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Barlesi
mesh_terms: D000465:Algorithms; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D001862:Bone Resorption / Q000517:prevention & control; D003661:Decision Support Techniques; D019583:Dose Fractionation, Radiation; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D011788:Quality of Life; D015641:Radiography, Interventional / Q000379:methods; D011878:Radiotherapy / Q000379:methods
chemical_list: D050071:Bone Density Conservation Agents
keywords: Algorithm; Algorithme; Anti-resorbtive; Anti-résorptifs; Bone metastasis; Chirurgie; Interventional radiology; Métastases osseuses; Radiologie interventionnelle; Radiotherapy; Radiothérapie; Surgery