Bulletin du cancer
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The orthopedic surgical treatment of metastases is very important in the treatment of osteophile cancers. The surgical option is always proposed after a multidisciplinary decision. ⋯ This risk has to be evaluated and a preventive treatment can often be performed. The surgical options are multiple: such as preventive osteosynthesis, pathological fracture treatment, reconstruction with prosthesis, carcinological excision… The choice of the treatment is support on the life expectancy and the functional risk of the metastatic bone lesion.
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The administration of a radionuclide in unsealed source whose radiation will destroy cells that have selectively accumulated product is called radiometabolic therapy. The management of bone pain is a major problem, particularly in cases of breast or prostate where the presence of metastases can remain compatible with long-term survival of cancer patients. In this context, the radiometabolic therapy reduces the pain secondary to bone metastases, in association or not with analgesics. ⋯ In this setting, the currently used substances are Metastron® and Quadramet®. Recently, a new product, radium chloride (or Alpharadin®) has shown efficacy in bone metastases from prostate cancer, particularly in terms of bone pain palliation, but also of increased overall survival. In addition, this product has virtually no hematologic toxicity.