ESTRO ACROP guidelines for external beam radiotherapy of patients with complicated bone metastases

This is the second part of the guidelines on the management of bone metastases. In the first part, the diag-nosis and management of uncomplicated bone metastases have been addressed.Bone metastases may significantly reduce quality of life due to related symptoms and possible compli-cations. The most common symptoms include pain and neurologic deficits. The most serious complica-tions of bone metastases are skeletal-related events (SRE), defined as pathologic fracture, spinal cord compression, pain, or other symptoms requiring an urgent intervention such as surgery or radiotherapy. Diffuse bone metastases may lead to hypercalcaemia that can be fatal if untreated. The growing access to modern diagnostic tools allows early detection of asymptomatic bone metastases that could be success-fully managed with local treatment if oligometastatic or systemic treatment for diffuse bone metastases to try to avoid the development of SRE.(c) 2022 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 173 (2022) 240-253

Automated summary

This article is the second part of the guidelines on the management of bone metastases, focusing on the clinical manifestations, complications, and the importance of early diagnosis and treatment.