Detection of Bone Metastasis On Whole Body Bone Scan Among Sudanese Patients with Proven Cancer in Tumours Therapy and Cancer Research Center –Shendi –Sudan
DOI:
https://doi.org/10.22376/ijtos.2025.3.1.21-39Keywords:
bony metastasis, bone scan, cancer patient, Shendi –SudanAbstract
Bony metastasis is one of the most common causes of death in patients with proven cancer, most of the patients present by pathological fracture, and carry poor prognosis. The bone scan is the main investigation for diagnosis. Our objective is to determine the most common cancer that causes metastasis, the commonest site involved in the skeleton, and the metastatic pattern for each cancer. We studied 150 cases collected in tumor therapy and cancer research centers, those who underwent bone scans using a gamma camera. The most age of our patients ranged between (40 and 60) years old. The predominance of females was noticed (68.7%). 90% of the patients were married. The study showed that 35.3% with left breast cancer, 20% with right breast cancer, and 22% with prostate cancer. The study showed that 40% of the participants had bone metastasis, 41.7% with prostate cancer, 21.7% with left breast cancer, and 16.7% with right breast cancer. The study showed that the lumber vertebra involved in 51.7% of bone metastasis, thoracic vertebra involved in (50%) with bone metastasis, the anterior ribs involved in 28.3% with bone metastasis, while posterior ribs in 25%, the right femur involved in 28.3 while the left femur engaged in 25% of bone metastasis and 25% metastasis to the skull. About 40% of the patients had bony metastasis. Breast and prostate are the most common cancers that cause bony metastasis. The spine is the most common site for metastasis. Prostate cancer metastasized mainly to the spine followed by the femur, ribs, skull, and shoulders
References
Jiang W, Rixiati Y, Zhao B, Li Y, Tang C, Liu J. Incidence, prevalence, and outcomes of systemic malignancy with bone metastases. Journal of Orthopedic Surgery. May 2020. doi:10.1177/2309499020915989
Murali Poduval, Skeletal System Anatomy in Adults, www.emedicine.medscape.com, Jul 28, 2015
Allen Gabriel, Breast Anatomy, www.emedicine.medscape.com, Jun 29, 2016
Nicolas A Muruve, Prostate Anatomy, www.emedicine.medscape.com, Sep 13, 2017 Page 768, 772, 781-782, 713-714, 668 in Robbins and Cotran pathologic basis of disease (Ninth edition), Kumar, V., Abbas, A. K., & Aster, J. C. (2015). Mechanisms of Bone Metastasis by G. David Roodman, New England Journal of Medicine, April 15, 2004. Mechanisms of bone metastasis, Gregory R. Mundy, ACS journals, Nov. 20, 2000.
Arnold I. Brenner DO, June Koshy, Jose Morey, Cheryl, and Jason DiPoce, The Bone Scan, Science Direct, November 22, 2011.
Valid Reza DabbaghKakhki 1, Pattern and distribution of bone metastases in common malignant tumors, Pubmed.gov, 2013, Kazem Anvari, Ramin Sadeghi, Anooshe-Sadat Mahmoudian, and Maryam Torabian-Kakhki.
Magid H. Amer, Genetic factors and breast cancer laterality, ncbi.nlm.nih.gov, 2014 Apr 16.
Keene JS, Sellinger DS, McBeath AA, Engber WD. Metastatic breast cancer in the femur. A search for the lesion at risk of fracture. Clin Orthop Relat Res. (203): 282–8; February 1986.
Santini D, Vincenzi B, Tonini G, Sammarra M, Quattrocchi CC, Piciucchi S, et al. Osteosclerotic lesions are more common in breast cancer bone metastases. Oct. 2007, Radiol Med. 112 (7): 1049–1059.
Alarmo EL, Kallioniemi A. Bone morphogenetic proteins: twofold function in carcinogenesis in breast cancer? Endocrine-related cancer. June 17, 2010 (2): R123-39...
Doot RK, Gralow JR, Specht JM, Peterson LM, Muzi M, Schubert EK, et al. Kinetic analysis of 18F-fluoride PET images of breast cancer bone metastases. J Nucl Med. 2010 Apr. 51 (4):521-7.
Hung JJ, Jeng WJ, Hsu WH, Wu KJ, Chou TY, Hsieh CC, et al. Prognostic factors of post-recurrence survival in completely resected stage I non-small cell lung cancer with distant metastasis. Thorax. 2010 Mar. 65 (3):241-5.
Edwards J. Src kinase inhibitors: an emerging treatment option for prostate cancer. Expert Opin Investing Drugs. 2010 May. 19 (5):605-14.
Bittner M, Wedin R, Bauer H, Tsagozis P. Outcome of surgical treatment for bone metastases caused by colorectal cancer. J Gastrointest Oncol. 2021 Oct. 12 (5):2150-2156.
British Orthopaedic Oncology Society and British Orthopaedic Association. Metastatic bone disease: a guide to good practice (2015 revision). British Association for Surgical Oncology. Available at https://baso.org.uk/media/61543/boos_mbd_2016_boa.pdf. 2015; accessed: March 13, 2024.
Zeng L, Chow E, Bedard G, Zhang L, Fairchild A, Vassiliou V, et al. Int J Radiat Oncol Biol Phys. 2012 Nov 1. 84 (3):e337-42. Quality of life following palliative radiation therapy for patients with painful bone metastases: findings of an international study validating the EORTC QLQ-BM22.Int J Radiat Oncol Biol Phys. 2012 Nov 1. 84 (3):e337-42. Quality of life following palliative radiation therapy for patients with painful bone metastases: findings of an international study validating the EORTC QLQ-BM22.
Frankel BM, Jones T, Wang C. A clinical assessment of segmental polymethylmethacrylate-augmented pedicle screw fixation in patients with osteoporosis-related bone softening and metastatic tumor involvement. Neurosurgery. 2007 Sep. 61 (3):531-7; discussion 537-8.
Orthopedic management of pelvic lesions and extremities, Harrington KD. Clin Orthop Relat Res. 312:136–47, Mar. 1995. Clin Orthop Relat Res. 312:136–47, Mar. 1995.
Mundy GR, Yoneda T. Facilitation and suppression of bone metastasis. Clin Orthop Relat Res. 1995 Mar. (312):34-44.
Elaasser B, Arakil N, Mohammad KS. Bridging the Gap in Understanding Bone Metastasis: A Multifaceted Perspective. Int J Mol Sci. 2024 Feb 29. 25 (5): Guise TA, Yin JJ, Taylor SD, Kumagai Y, Dallas M, Boyce BF, et al. Evidence linking parathyroid hormone-related protein to the pathophysiology of osteolysis-mediated human breast cancer. J Clin Invest. 1996 Oct 1. 98 (7):1544-9.
Cancer statistics. National Cancer Institute. Available at https://www.cancer.gov/aboutcancer/understanding/statistics. September 25, 2020; accessed: March 13, 2024.
Turpin A, Duterque-Coquillaud M, Vieillard MH. Bone Metastasis: Current State of Play. Transl Oncol. 2019 Dec 23. 13 (2):308-320.
Key statistics about bone cancer. American Cancer Society. Available at https://www.cancer.org/cancer/bone-cancer/about/key-statistics.html. January 12, 2023; accessed: March 13, 2024.
Jawad MU, Pollock BH, Wise BL, Zeitlinger LN, O'Donnell EF, Carr-Ascher JR, et al. Sex, racial/ethnic, and socioeconomic disparities in patients with metastatic bone disease. J Surg Oncol. 2022 Mar. 125 (4):766-774.
Harrington KD. Orthopedic surgical management of skeletal complications of malignancy. Cancer. 1997 Oct 15. 80 (8 Suppl):1614-27.
Yazawa Y, Frassica FJ, Chao EY, Pritchard DJ, Sim FH, Shives TC. Metastatic bone disease. A study of the surgical treatment of 166 pathologic humeral and femoral fractures. Clin Orthop Relat Res. 1990 Feb. (251):213-9...
Hirbe AC, Morgan EA, Weilbaecher KN. The CXCR4/SDF-1 chemokine axis: a potential therapeutic target for bone metastases? Curr Pharm Des. 2010. 16 (11):1284-90.
Kirkinis MN, Spelman T, May D, Choong PFM. Metastatic bone disease of the pelvis and extremities: rationalizing orthopedic treatment. ANZ J Surg. 2017 Nov. 87 (11):940-944.
Baumber R, Gerrand C, Cooper M, Aston W. Development of a scoring system for survival following surgery for metastatic bone disease. Bone Joint J. 2021 Nov. 103-B (11):1725-1730...
Nakanishi K, Hijikata Y, Uchino K, Sugimoto Y, Iba H, Watanabe S, et al. Predicting Skeletal-related Events Using SINS. Spine (Phila Pa 1976). 2024 Mar 13.
Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relate Res. 1989 Dec. (249):256-64.
Hipp JA, Springfield DS, Hayes WC. Predicting pathologic fracture risk in the management of metastatic bone defects. Clin Orthop Relat Res. 1995 Mar. (312):120-35.
F-fluoride uptake in bone metastasis: morphologic and metabolic analysis on integrated PET/CT, Kawaguchi M, Tateishi U, Shizukuishi K, Suzuki A, Inoue T. May 2010, Ann Nucl Med. 24 (4):241-7.
Richhariya A, Shore ND, Wang H, Chung K, and SJ all had freed land. Treatment regimens in US community-based urology group practices for patients with bone metastases and prostate cancer. Aug. 2012; 80 (2):293-8; Urology.
Callstrom MR, Dupuy DE, Solomon SB, Beres RA, Littrup PJ, Davis KW, et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer. 2013 Mar 1. 119 (5):1033-41.
Haider MT, Smit DJ, Taipaleenmäki H. MicroRNAs: Emerging Regulators of Metastatic Bone Disease in Breast Cancer. Cancers (Basel). 2022 Jan 30. 14 (3):
Raje N, Terpos E, Willenbacher W, Shimizu K, García-Sanz R, Durie B, et al. An international phase 3 trial that was randomized, double-blind, double-dummy, controlled, and randomized compared denosumab and zoledronic acid to treat bone disease in patients with recently diagnosed multiple myeloma. Mar. 19, 2018; Lancet Oncol. 19 (3): 370–381.
Bakhshandeh M, Mofid B, Sahinbas H, Faeghi F, Mirzaei H, et al., Faghihi Moghaddam F. The clinical effectiveness of external beam radiation therapy (EBRT) alone versus EBRT plus whole-body hyperthermia was investigated in patients with painful bony metastases in a phase III clinical trial. 2024 Feb 23; J Therm Biol 120:103804, 2024.
Sacino AN, Rhines LD, Chen H, Sahgal A, Bettegowda C, Maralani P, and others. A new standard of care for spinal metastases is stereotactic body radiation therapy. 2024 Mar 4. 26 (Supplement_1): S76–S87. Neuro Oncol.
Barrett-Lee P, Simmonds P, Hood K, Coleman R, Abraham J, Casbard A, et al. This phase 3 study compared oral ibandronic acid with intravenous zoledronic acid for the treatment of bone metastases from breast cancer. It was non-inferiority, open-label, and randomized. 2014 Jan 15 (1):114–22; Lancet Oncol.Bisphosphonates and additional bone agents as treatments for breast cancer: Wong MH, Stockler MR, Pavlakis N. Cochrane Database Syst Rev. 2012; 2:CD003474, February 15.
Irelli A, Zugaro L, Di Staso M, Cannita K, Cocciolone V, Lanfiuti Baldi P, et al. Bone-targeted therapy to avoid skeletal-related complications in patients with breast cancer that has spread. Bone. 2016 Jun. 87:169-75.
Yu X, Zhu L. Nanoparticles for the Treatment of Bone Metastasis in Breast Cancer: Recent Advances and Challenges. Int
J Nanomedicine. 2024. 19:1867-1886. Zaikova O, Fosså SD, Bruland OS, Giercksky KE, Sandstad B, Skjeldal S. Radiotherapy or surgery for spine metastases? Acta Orthop. 2011 Jun. 82 (3):365-71.
Errani C, Bazzocchi A, Spinnato P, Facchini G, Campanacci L, Rossi G, et al. What's new in the management of bone metastases? Eur J Orthop Surg Traumatol. 2019 Oct. 29 (7): 1367-1375.
Orita Y, Sugitani I, Matsuura M, Ushijima M, Tsukahara K, Fujimoto Y, et al. Prognostic factors and the therapeutic strategy for patients with bone metastasis from differentiated thyroid carcinoma. Surgery. 2010 Mar. 147 (3):424-31. Sebghati J, Khalili P, Tsagkozis P. Surgical treatment of metastatic bone disease of the distal extremities. World J Orthop. 2021 Oct 18. 12 (10):743-750.
Redmond KJ, Lo SS, Soltys SG, Yamada Y, Barani IJ, Brown PD, et al. Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey. The Journal of Neurosurg Spine, Mar. 26, 2017, 396–307.
Clayer MT, Tang X. Low risk of cardiac events during intramedullary instrumentation of lung cancer metastases. Acta Orthop. 2007 Aug. 78 (4):547-50.
Camnasio F, Scotti C, Peretti GM, Fontana F, Fraschini G. Prosthetic joint replacement for long bone metastases: analysis of 154 cases. Arch Orthop Trauma Surg. 2008 Aug. 128 (8):787-93. Forauer AR, Kent E, Cwikiel W, Esper P, Redman B. Selective palliative transcatheter embolization of bone metastases from renal cell carcinoma. Acta Oncol. 2007. 46 (7):1012-8.
Chow E, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JS, et al. Single versus multiple fractions of repeat radiation for painful bone metastases: a randomized, controlled, non-inferiority trial. Lancet Oncol. 2014 Feb. 15 (2):164-71.
Nieder C. Repeat palliative radiotherapy for painful bone metastases. Lancet Oncol. 2014 Feb. 15 (2):126-8.
Lutz S, Balboni T, Jones J, Lo S, Petit J, Rich SE, et al. Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline. Pract Radiat Oncol. 2017 Jan.-Feb. 7 (1):4-12
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