Percutaneous radiotherapy of bone metastases

Percutaneous radiotherapy is effective in the treatment of bone metastases. Pain, threatening fracture, manifest fracture and compression by tumour mass are indications for local irradiation. Radiotherapy is also indicated in recurrence prevention after surgical intervention. Bone metastases are treated with a spatial and functional margin. Dose patterns vary considerably with single doses of between 2 and 8 Gy and total doses between 8 and 50 Gy. Radiotherapy leads to amelioration and preservation of the quality of life due to pain reduction, and also local stagnation of tumour growth. The pain symptom response rate is 80-90% and complete remission amounts to 50%. Radiologically, the recalcification rate is 5-70% for all tumour entities. Disseminated painful bone metastases in breast, lung and prostate carcinoma and non-Hodgkins lymphoma are primarily the indication for hemibody irradiation which, however, is declining due to improved pharmacological pain treatment and effective antiosteoclastic (bisphosphonates) treatment. © Springer Medizin Verlag 2005.