10. Bone Metastases
Origin: most common sites
of origin (primary) are lung,
breast, prostate and kidney
Symptoms: pain (esp at night), possible
fracture or nerve compression , may
cause elevated calcium level or lead to
anemia
11. ribs
Most common
sites for bone
spine
metastases
pelvis
femurs
12. Some bone mets
make the bone look
too white
(osteoblastic)
others make dark
holes (lytic)
26. A typical course of
radiation is 10
treatments ( in some
cases it is necessary
to go slower, 20 to
25 trips)
Bone met at L2
Radiation field
27. Side Effects of Radiation for Bone mets
•Mild fatigue
•Local skin irritation
•Lower the blood count
(anemia or white count)
•The bone can temporarily
get weaker before
strengthening
28. Local Side Effects of Radiation for Bone mets
Sore throat or dry mouth
Trouble swallowing , heart burn
or dry cough
Loose bowels or cramps
Bladder or rectal irritation
29. Radiation Results
•80 - 90% of the time the
symptoms improve
•Complete relief in 54%
•Most respond by 10-14 days,
70% by 2 weeks, 90% by 3
months
•55 - 70% pain benefit is
sustained for life
30. Can You Radiate a Bone Metastasis a
second time if the cancer flares up?
Effectiveness of Reirradiation for Painful Bone Metastases: A Systematic
Review and Meta-Analysis (IJROBP 2012:84:8)
Of the 2,694 patients initially treated for
metastatic bone pain, 527 (20%) patients
underwent reirradiation.
Overall, a pain response after reirradiation
was achieved in 58% of patients