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Bone metastasis, or osseous metastatic disease, is a category of cancer metastases that result from primary tumor invasions into bones. Bone-originating primary tumors such as osteosarcoma , chondrosarcoma , and Ewing sarcoma are rare; the most common bone tumor is a metastasis. [ 1 ]
Reliable and valid statistics on the incidence, prevalence, and mortality of malignant bone tumours are difficult to come by, particularly in older adults (those over 75 years of age) - because carcinomas that are widely metastatic to bone are rarely ever curable. Biopsies to determine the origin of the tumour in cases like this are rarely done.
General treatment regimens have not changed much in the past 30 years, in part due to the lack of randomized clinical trials. [4] Surgery is the treatment of choice if the tumor is determined to be resectable. Curettage is a commonly used technique. [12] The situation is complicated in a patient with a pathological fracture.
In November 2024, the CHMP adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Xbryk, intended for the prevention of bone complications in adults with advanced cancer involving bone and for the treatment of adults and skeletally mature adolescents with giant cell tumor of bone. [45]
If metastases are both local and regional, the prognosis is worse. Initial presentation of stage III osteosarcoma with lung metastases depends on the resectability of the primary tumor and lung nodules, degree of necrosis of the primary tumor, and maybe the number of metastases. Overall survival prognosis is about 30%.
A major use of systemic radioisotope therapy is in the treatment of bone metastasis from cancer. The radioisotopes travel selectively to areas of damaged bone, and spare normal undamaged bone. Isotopes commonly used in the treatment of bone metastasis are radium-223, [113] strontium-89 and samarium (153 Sm) lexidronam. [114]
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