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Combined Radiotherapy and Bisphosphonates: State of Art

  • Chapter
Bone Metastases

Part of the book series: Cancer Metastasis – Biology and Treatment ((CMBT,volume 12))

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Abstract

In the event of malignancy bone metastases are common and are inevitably accompanied with potentially serious complications that may deteriorate the clinical and performance status (PS) of patients, or even threaten life. Both radiotherapy (RT) and bisphosphonates (BPs) have an established and important role in the management of metastatic bone disease when applied as monotherapies. Their concomitant use may though result in a synergistic or additive effect that may bring about an improved therapeutic outcome as evidenced through radiologic (objective) and clinical (objective) evaluations.

The current chapter describes in detail the potential interactions between BPs and RT and presents the results of both clinical and animal studies implementing their concurrent use. Through clinical studies a considerable reduction of the mean patient pain scores was noted, accompanied by a marked limitation of the opioid analgesic need. Similarly, a significant improvement of the patient’s quality of life (QOL) and PS scores was noted. The worth noticing clinical response was associated with an enhanced reossification of metastatic bone lesions. This may be responsible for the marked improvement of the clinical status of patients, since it has been shown that bone density has a strong, negative and statistically significant correlation with pain (the main factor affecting negatively both the PS and QOL of evaluated patients). The results of animal studies involving tumor induced osteolysis reinforce our hypothesis about the synergistic activity between BPs and RT, since their concurrent application was shown to bring about a significant increase of bone density and an improved bone stability, biomechanical strength and micro-architecture.

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Authors and Affiliations

  1. Dept. of Radiation Oncology, University of Patras Medical School, 26500 Patras, Greece

    Vassilios Vassiliou & Dimitrios Kardamakis

Authors
  1. Vassilios Vassiliou
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  2. Dimitrios Kardamakis
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Correspondence to Vassilios Vassiliou .

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Editors and Affiliations

  1. Dept. of Radiation Oncology, University of Patras Medical School, 265 04, Patras, Greece

    Dimitrios Kardamakis MD, PhD, DMRT  & Vassilios Vassiliou MD, PhD  & 

  2. Dept. of Radiation Oncology, University of Toronto Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada

    Edward Chow MBBS, PhD, FRCPC

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Vassiliou, V., Kardamakis, D. (2009). Combined Radiotherapy and Bisphosphonates: State of Art. In: Kardamakis, D., Vassiliou, V., Chow, E. (eds) Bone Metastases. Cancer Metastasis – Biology and Treatment, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9819-2_11

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