Uptodate 2015

Bone metastases are a common manifestation of distant relapse from many types of solid cancers, especially those arising in the lung, breast, and prostate. As many as 80% of patients with solid tumors will develop painful bone metastases to the spine, pelvis, and extremities during the course of their illness [1].

The goals of palliative treatment of bone metastases are pain relief, preservation of function, and maintenance of skeletal integrity. When bone pain is limited to a single or a limited number of sites, local field external beam radiation therapy (RT) to the painful sites can provide pain relief in approximately 60 to 85% of cases, with complete pain response reported in 15 to 58% [2]. If symptomatic lesions are widespread, radiopharmaceuticals or hemibody radiation may provide useful palliative alternatives. Although treatment can be effective for patients with mild, moderate, or severe pain, early intervention may be useful in maintaining quality of life and minimizing side effects of analgesic medications [3].