Treatment outcome of bone metastasis : Mahavajiralongkorn Thanyaburi Hospital Experience

Abstract

Introduction Bone is a commonly metastatic site from several common cancers such as breast, kidney, lung, multiple myeloma, prostate and thyroid gland. Radiotherapy and medical treatments can relieve pain, prevent complications, improve functioning and quality of life. In Mahavajiralongkorn Thanyaburi Hospital, there is no reported data about management of bone metastasis. This retrospective study is conducted to evaluate the treatment modalities, median survival and overall survival. Material and methods Retrospective, descriptive study of patients with bone metastasis who received treatment in Mahavajiralongkorn Thanyaburi Hospital between 1 January 2006 and 31 December 2007 and were followed up to 30 July 2010. Results A total of 111 patients received treatments of bone metastasis; 63 (56.76%) were females and 48 (43.24%) were males. The three most common primary cancer sites were lung (29 patients, 26.13%), breast (26 patients, 23.42%) and thyroid (13 patients, 11.71%). Radiotherapy was the main treatment of our patients. Median follow-up time was 3 months (mean = 8 months, ranged from 0.25-55 months). The overall median survival time was 3.00 ± 0.32 months (95%CI = 2.38-3.61), 1-year and 2- years survival rates were 22% and 12%, respectively. Thyroid cancer had the longest median survival (MS) time (34.00 ± 15.27 months, 95%CI = 4.07-63.93), with 1-year and 2- years survival rate of 77% and 52%, respectively. The factors which effected on MS were bone metastasis at initial presentation versus develop bone metastasis later (MS, 3.00 vs. 7.00 months), primary tumor controlled vs. uncontrolled (MS, 7.00 vs. 3.00 months), patients had symptom from bone metastasis vs. without symptom (MS, 3.00 vs. 6.50 months) and patients had bone metastasis alone vs. multiple organ metastases (MS, 4.00 vs. 2.50 months) Conclusions Radiotherapy was the main treatment of our bone metastasis patients. Thyroid cancer with bone metastasis patients had excellent clinical outcome. Remarkable poor prognostic factors included bone metastasis at initial presentation, uncontrolled primary tumor, symptomatic bone metastasis and multiple organ metastases.