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Palliative radiotherapy for bone metastases in elderly patients improves quality of life
Date:4/22/2013

poorer performance status when they joined the trial and the higher percentage of male patients, who were more likely to have prostate cancer. Women were more likely to have breast cancer, which often responds better to treatment than lung or prostate cancer.

The three main groups of primary tumours in the patients studied were breast (39%), prostate (23%) and lung cancers (25%). The remaining 13% comprised a variety of primary tumours, such as bladder cancer, rectal cancer, and oesophageal cancer. The group was made up 54% men and 46% women.

"We saw that the type of primary tumour had an effect on the response to treatment," said Dr Westhoff. "For example, patients with lung cancer had less chance of response than those with breast or prostate cancer. We believe that this variety in response is due to the aggressiveness of the disease and the limited ability to treat it with systemic agents."

Bone metastases develop when cancer cells from primary tumours migrate to the bone, causing it to weaken over a period of time. They can cause pain, which can be severe and debilitating, compression of the spinal cord, fractures, spinal instability, anaemia, and significant degeneration of quality of life. Bone is one of the most common places for cancer to spread and, once there, the cancer cells settle in their new environment and continue to grow.

The pain from bone metastases arises through stretching of the periosteum, the membrane lining the external surface of the bone and which contains many nerve endings. The stretching activates pain receptors, and chemical mediators of pain such as prostaglandins also play a role. The precise pain-killing mechanism of radiotherapy in these cases is unknown; it is not solely due to tumour shrinkage, say the researchers, because the onset of response can be very rapid. More likely it is a response mechanism involving chemical mediators such as prostaglandin that causes the pain relief.

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Contact: Mary Rice
mary.rice@riceconseil.eu
European Society for Radiotherapy and Oncology (ESTRO)
Source:Eurekalert

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