Radiation Treatment Decreases Bone Cancer Pain, Osteolysis and Tumor Size

Goblirsch, Michael; Mathews, Wendy; Lynch, Christine M.; Alaei, Parham; Gerbi, Bruce J.; Mantyh, Patrick W.; Clohisy, Denis R.

doi:10.1667/rr3108

Cited by 57 publications

(36 citation statements)

References 16 publications

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“…It is produced by cytokines released from tumour mass in low pH tumour-environment. These cytokines stimulate osteoklasts to osteolysis, and afferent nerve fibers [6,7,12]. This type of pain may be successfully treated with anti-inflammatory drugs.…”

Section: Clinical Presentation and Imagingmentioning

confidence: 99%

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Management of Metastatic Tumours to the Cervical Spine

Kröber¹

2015

J Spine

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The spinal column is the most common site of skeletal secondary tumours. Metastatic tumours spreading to spine cause growing problem to the aging population. Patients suffer from immobilizing pain, instability of the spine and secondary neurologic deficits. In most patients treatment is palliative. By improving therapy of tumour-induced instability of the spine and tumour-induced pain, patients' quality of life can be significantly improved and medical costs significantly lowered. In the past, the traditional therapy of metastatic spinal tumours was based on fractionated external beam radiotherapy. Surgical approach was limited to laminectomy (decompression). Nowadays, surgery focuses on preservation and restoration of neurologic function and stability of the spine by marginal resection, and immediate posterior and anterior stabilization. In addition, development of new surgical techniques such as radiofrequency thermoablation and kyphoplasty allowed surgeons address some of the problems related to lytic destruction of the vertebra without increasing morbidity and mortality of the patients associated with open surgery. However, proper treatment of the cervical spine metastases can be achieved only by multidisciplinary team work.

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Section: Clinical Presentation and Imagingmentioning

confidence: 99%

“…It is not known, how local irradiation decreases cancer-induced pain. Some reports suggested that radiation decreased viable tumour mass, and secondary reduced amount of cytokines and growth factors which activated osteoclasts in tumour-bone microenvironment [6,7].…”

Section: Introductionmentioning

confidence: 99%

Management of Metastatic Tumours to the Cervical Spine

Kröber¹

2015

J Spine

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“…176 When sarcoma cells (10 5 in 20 μl) were implanted into mouse femurs to examine the effects of 20-Gy and 30-Gy radiation as a means to control cancer pain, these radiation therapies effectively decreased cancer-induced osteolysis, reduced tumor size by 75%, and decreased bone cancerrelated pain. [57][58][59] Radiation therapy also successfully controlled pain and skeletal fractures associated with femoral implantation of 4T1 breast carcinoma cells into mice. 59 These studies demonstrated that radiation therapy effectively decreased cancer-induced pain by direct effects on tumor cells.…”

Section: Models Of Cancer Painmentioning

confidence: 99%

Animal Models of Cancer Pain

Pacharinsak

Beitz²

2010

Animal Models of Pain

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220Pain is one of the most common and distressing symptoms experienced by both human and veterinary oncology patients with advanced cancer. In humans, unrelieved pain can disrupt and interfere with activities of daily living, quality of life, and mood, 26,173 and domestic animals typically are euthanized when pain is no longer adequately controlled. 138 New developments in cancer detection and therapy have occurred over the past decade. These developments are contributing to longer life expectancies and have raised important issues related to quality of life, as attention has focused increasingly on how to manage cancer pain effectively. 91,115,134 This increased attention is true in the fields of both human and veterinary medicine. Human cancer patients who are in advanced stages of the disease, particularly those with bone metastasis, report that they experience significant pain, and pain intensity appears to be related to the degree of bone destruction. Similarly, pain secondary to cancer in domestic animals is a key concern in veterinary practice and should be addressed promptly to alleviate suffering, stress, and anxiety and to improve quality of life. Not only do cancer patients have to deal with persistent pain, they also often experience 'breakthrough pain.' Breakthrough pain-intermittent episodes of extreme pain-occurs spontaneously or after movement or weight-bearing of the affected leg. 114,133 Canine osteosarcoma has many clinical and biological similarities to human osteosarcoma, and affected dogs show signs of both ongoing and breakthrough pain. 37 In addition to cancer-induced pain, human patients also experience pain caused by the very therapies used to treat the cancer. Almost 30% of adult cancer patients and 60% of pediatric cancer patients who have undergone treatments that include radiation, chemotherapy, or surgery also have experienced pain resulting from these therapeutic procedures. 49,174 Whether radiation treatment and chemotherapy also induce pain in domestic animals is virtually impossible to address, because carefully controlled studies have not examined this issue.Pain intensity varies among cancer patients and is dependent on a patient's pain sensitivity, the type of cancer, and the tumor location. 48,49 Cancer treatment guidelines provided by the World Health Organization have been used in oncology and pain treatment clinics. 20,25,92,113,117,119,163 Treatment of human cancer patients include the use of opioids, nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids, local anesthetics, antidepressants, and anticonvulsants either alone or in combination. Similarly in veterinary medicine, the goal of palliative therapy in cancer patients is to control pain from an incurable tumor and to support overall quality of life. 165 Therefore, opioids, NSAIDs, and bisphosphonates are used in addition to surgery and radiation therapy and are the drugs of choice in treating domestic animals with cancer pain, particularly those suffering from osteosarcoma and other forms of bone cancer. 1...

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“…In rats, because of the large bone size, it is possible to inject tumor cells percutaneously into the tibia without performing a knee stifle [Medhurst et al, 2002]. With mice, because of diminutive bone size, tumor cells are injected into the humerus or femur after a surgical knee stifle [Wacnik et al, 2003;Goblirsch et al, 2004]. Direct, local intramedullary injection of tumor cells is advantageous over systemic intravenous or intracardiac administration because the skeletal site where the tumor develops is known, allowing for analysis of corresponding behavioral and neuroanatomic segments.…”

Section: Animal Models Of Bone Cancer Painmentioning

confidence: 99%

“…More recently, Goblirsch et al has suggested that reduced tumor burden and reduced osteolysis are the principal contributors through which radiation improves cancerinduced bone pain (Fig. 3) [Goblirsch et al, 2004].…”

Section: Therapies For Cancer-induced Bone Painmentioning

confidence: 99%