bims-rebome 2025-11-23 papers

Support Care Cancer. 2025 Nov 17. 33(12): 1073

The Bone Metastases and Exercise (BME) Hub: a MASCC-endorsed knowledge mobilization initiative to advance exercise recommendations for people with bone metastases.

DOI: https://doi.org/10.1007/s00520-025-10123-6

Radiother Oncol. 2025 Nov 15. pii: S0167-8140(25)05288-0. [Epub ahead of print] 111284

Course of quality of life in short- and long-term survivors after radiotherapy for bone metastases.

Eline H Huele, Renée Hovenier, Bas B J Bindels, Anouk van Oss, Rene H Kuijten, Roxanne Gal, Bart J Pielkenrood, Jorrit-Jan Verlaan, Nicolien Kasperts, Wietse S C Eppinga, Yvette M van der Linden, Joanne M van der Velden, Helena M Verkooijen.

BACKGROUND: Bone metastases often cause pain and interfere with quality of life (QoL). Survival of patients with bone metastases is increasing and there is a paucity of data about QoL in long-term survivors after external beam radiotherapy.
METHODS: Patients with bone metastases treated with radiotherapy were identified from the PRospective Evaluation of interventional StudiEs on boNe meTastases (PRESENT+) cohort. Patient and treatment characteristics were collected before radiotherapy. Patient-reported QoL scores were collected up to 5 years, and included global QoL, physical and emotional functioning, symptoms including pain (EORTC QLQ-C15 PAL) and functional interference and psychosocial aspects (EORTC QLQ-BM22). Dutch reference QoL data were used for comparison.
RESULTS: In total, 458 (23 %) short-term (<3 months), 915 (46 %) intermediate-term (≥3 months and < 2 years), and 603 (31 %) long-term (≥2 years) survivors were included. Median survival of the full cohort (n = 1,976) was 9.5 months (interquartile range, 3.3-30.5 months). Two third (n = 1,316, 67 %) provided QoL scores. Long-term survivors reported a substantial increase in global QoL, emotional and physical functioning, and functional interference 4 weeks post radiotherapy; this improvement persisted over 5 years. Their QoL scores were substantially better than those of short-term and intermediate-term survivors, and somewhat lower than the reference population.
CONCLUSION(S): Patients with bone metastases, referred for radiotherapy, represent a highly heterogeneous group. One third survives more than two years with QoL scores comparable to, or somewhat lower than the Dutch reference population. An individualized treatment approach is needed, addressing both short-term symptom palliation and, if applicable, long-term goals.

Keywords: Bone metastases; Conventional radiotherapy; Long-term survivors; Quality of life; Radiotherapy; Stereotactic body radiotherapy

DOI: https://doi.org/10.1016/j.radonc.2025.111284

J Orthop. 2026 Jan;71 275-290

Surgical treatment of metastatic epidural spinal cord compression: a systematic review and meta-analysis.

Mingjiang Luo, Ruidi He, Zhifeng Tang, Jiaxuan Mo, Yuxin Yang, Zhihong Xiao.

Background: Although surgery has become an important treatment modality for metastatic spinal tumors with epidural spinal cord compression (MESCC), its efficacy has not been systematically confirmed. This meta-analysis aimed to comprehensively evaluate the effectiveness of surgical treatment for MESCC and to examine the influence of patient characteristics on the incidence of postoperative complications.
Methods: A systematic search was conducted in PubMed, Embase, and the Cochrane Library for relevant studies published on or before March 5, 2025. A random-effects model was employed for data synthesis. Continuous outcomes were reported as standardized mean differences (SMD), while single-arm incidence rates were expressed as odds ratios (ORs) with 95 % confidence intervals (CIs). Subgroup analyses and leave-one-out sensitivity analyses were performed to explore sources of heterogeneity and the robustness of the results. Publication bias was assessed by visual inspection of funnel plot symmetry and statistical testing using Egger's and Begg's methods.
Results: A total of 67 cohort studies comprising 5377 patients were included. The pooled incidence of postoperative complications was 23.0 % (95 % CI: 19.0 %-27.0 %). Specific complication rates were as follows: cerebrospinal fluid leakage, 4.0 % (95 % CI: 2.0 %-7.0 %); pneumonia, 5.0 % (95 % CI: 4.0 %-6.0 %); wound dehiscence, 3.0 % (95 % CI: 2.0 %-5.0 %); and wound infection, 5.0 % (95 % CI: 4.0 %-6.0 %). Clinically relevant outcomes demonstrated postoperative improvements in VAS, ODI, ECOG, and ESCC scores, while BI, KPS, and ASIA scores significantly increased compared to preoperative values.
Conclusion: Surgical intervention for MESCC appears to offer meaningful improvements in functional and clinical outcomes. However, the risk of postoperative complications remains non-negligible and is significantly influenced by patients' baseline characteristics. These findings should be interpreted with caution due to the limited number of events for some complications, but they nonetheless provide valuable insights for clinical decision-making in the management of metastatic spinal tumors.

Keywords: MESCC; Meta-analysis; Metastatic epidural spinal cord compression; Surgical treatment; Systematic review

DOI: https://doi.org/10.1016/j.jor.2025.10.001

J Neuroendocrinol. 2025 Nov 18. e70115

Bone metastases from neuroendocrine neoplasms: Results of an Italian nationwide survey of natural history and management.

Bone metastases (BMs) were reported in <15% of cases of neuroendocrine neoplasms (NENs). Their clinical behavior is various and clinical management is still undefined. This study aimed to describe the clinical practical management and survival outcome of neuroendocrine neoplasm patients with BMs. This is a retrospective, observational, multicenter, nationwide study, in which clinical-pathological characteristics, diagnostic tools, skeletal-related events (SREs), bone targeted agents (BTAs) and their correlation with clinical outcome were collected. Data from 320 patients from 18 Italian centers diagnosed with bone metastases during 2000-2013 were captured. Most patients had a well/moderately differentiated NEN, with synchronous distant metastases, mostly hepatic, the majority of which originated from a gastroenteropancreatic primary site. Bone was the first metastatic site in 41% of patients. After a median follow-up of 27 months 122 patients died. The median overall survival (OS) was 62 months. In 22% of patients (n = 72), SREs were observed, and 31% of patients received a BTA. At multivariable analysis of factors associated with OS after the development of BMs, primary lung site, Ki-67 ≥55% versus ≤20%, >10 BMs, mixed pattern (osteoblastic/osteolytic) versus osteoblastic, prior lung metastases and SREs were found to be significant poor prognosis factors. At multivariable analysis Ki-67 ≥55% versus ≤20% remains significantly associated with the development of SREs. Our study represents a real-life nationwide scenario of a large series of NEN patients with BMs handled at dedicated centers. Several hypotheses generated by this study are warranted to be tested in future homogeneous studies, including objective criteria for the use of BTAs.

Keywords: bone metastases; neuroendocrine neoplasms; skeletal related events

DOI: https://doi.org/10.1111/jne.70115