Journal of Case Reports and Reviews in Medicine (ISSN: 3069-0749)
Review Article Volume: 2 & Issue: 1
Abstract
Bone metastases are a frequent and clinically consequential manifestation of advanced malignancy, contributing significantly to pain, skeletal-related events like fractures and impaired quality of life. With improvements in systemic therapies, patients are living longer with metastatic disease, making optimal management of bone metastasis a major determinant of morbidity and quality of life. Radiotherapy remains a central component of treatment, evolving from purely palliative intent to a modality capable of durable local control in selected patients.
This narrative review synthesizes evidence from randomized trials, observational studies, translational research and contemporary international guidelines. It addresses the classification, prognosis and multimodality treatment of bone metastases, with particular emphasis on radiotherapy. Bone metastases arise via a complex tumor–bone microenvironment interactions and present as osteolytic, osteoblastic or mixed lesions. Management requires a multidisciplinary approach integrating systemic therapy, bone-modifying agents, interventional procedures or radiotherapy. Conventional external beam radiotherapy (EBRT) provides reliable pain palliation, while stereotactic body radiotherapy (SBRT) offers superior local control, reduced re-irradiation with potential disease-modifying effects in oligometastatic and selected high-risk patients. Radiotherapy remains indispensable in the management of bone metastases. Contemporary evidence supports individualized treatment selection based on prognosis, disease burden keeping in mind the anatomical considerations, with increasing adoption of stereotactic techniques in appropriately selected patients.