Abstract

Radiation Therapy (RT) target determination for irradiation of bone metastases with soft tissue component: Impact of multimodality imaging

Highlights

  • Bone metastases are among the frequent complications of systemic cancer, and a significant proportion of patients suffer from bone metastases during the course of their malignant disease [1]

  • Definition of ground truth target volume was performed by the board certified radiation oncologists following meticulous evaluation, colleague peer review, collaboration, and ultimate consensus

  • Comparative assessment in our study revealed that ground truth target volume was identical with target volume definition by Computed Tomographhy (CT)-MR fusion based imaging

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Summary

Introduction

Bone metastases are among the frequent complications of systemic cancer, and a significant proportion of patients suffer from bone metastases during the course of their malignant disease [1]. Most frequently affected site includes the vertebrae followed by femur, pelvic bones, ribs, sternum, humerus, and skull. While aymptomatic presentation may be present, affected patients may suffer from a variety of symptoms depending on metastatic disease location, extent and association with critical neurovascular structures. Skeletal related events due to bone metastases may include pain, compression of nerve roots and the spinal cord, hypercalcemia, myelophthisis, and pathological fractures which could lead to severe consequences and quality of life impairment. Pain is a very frequent symptom of bone metastases [1,2]. Osteoclasts are thought to play significant role in pathophysiology, and injury of bone and nerve fibers may be responsible for occurrence of pain with both a nociceptive and neuropathic component [3-6]

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