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Review
. 2023 Aug 2:42:100496.
doi: 10.1016/j.jbo.2023.100496. eCollection 2023 Oct.

Optimal timing for local ablative treatment of bone oligometastases in non-small cell lung cancer

Jayoung Lee  1 , Jung A Kim  2   3 , Tai Joon An  2 , Hyochun Lee  4 , Eun Ji Han  5 , Young Jo Sa  6 , Hyo Rim Kim  7 , Chan Kwon Park  2 , Tae-Jung Kim  8 , Jeong Uk Lim  2
Affiliations
Review

Optimal timing for local ablative treatment of bone oligometastases in non-small cell lung cancer

Jayoung Lee et al. J Bone Oncol. .

Abstract

Oligometastases is a term commonly used to describe a disease state characterized by a limited number of distant metastases, and represents a transient phase between localized and widespread systemic diseases. This subgroup of stage IV cancer has increased in clinical importance due to the possibility of curative rather than palliative treatment. Among advanced lung cancer patients, 30-40% show bone metastases, and can show complications such as pathological fractures. Many prospective studies have shown efficacy of localized treatment in oligometastatic non-small cell lung cancer (NSCLC) in improving progression-free survival and overall survival. Compared to metastases in other organs, bone metastases are unique in terms of tumor microenvironment and clinical outcomes. Radiotherapy is the most frequently used treatment modality for local ablative treatment for both primary and metastatic lesions. Stereotactic body radiation therapy demonstrated more rapid and effective pain control compared to conventional 3D conformal radiotherapy. Radiotherapy improved outcomes in terms of time-to-skeletal related events skeletal-related events (SRE), hospitalization for SRE, pain relief, and overall survival in patients with bone metastases. Decision on timing of local ablative treatment depends on patient's overall clinical status, treatment goals, potential side effects of each approach, and expected initial responses to systemic anti-cancer treatment.

Keywords: Bone; Curative; Non-small cell lung cancer; Oligometastases; Radiotherapy; Stage IV.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Suggested algorithm regarding management of bone oligometastses in non-small cell lung cancer. Abbreviation: LAT, local ablative treatment.
See this image and copyright information in PMC

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