Prise en charge par radiothérapie des métastases osseuses et de leurs complications : les standards

Sixty percent of cancer patients have or develop bone metastases during the development of their cancer. Bone metastases are the most common cause of cancer-related pain. External radiation therapy is the standard treatment of uncomplicated bone metastases, for the treatment of pain, the prevention of fracture, and for tumor control. Fractionation schedules (one session of 8 Gy or several sessions, typically 30 Gy in 10 fractions) vary in terms of efficacy with however more retreatments after a single session. The treatment of spinal cord compression is classically based on radiotherapy associated or not with surgery with indications assessed in emergency by a multidisciplinary team. The use of prognostic scores and prospective studies including patients corresponding to the daily practice and the work of groups like the GEMO aim to harmonize and optimize the management of bone metastases.