Razaq Wajeeha
Stephenson Cancer Center, The University of Oklahoma, Norman, OK 73104, USA.
J Clin Med. 2013 Oct 14;2(4):176-87. doi: 10.3390/jcm2040176.
Cancer metastasis to the bone develops commonly in patients with various malignancies, and is a major cause of morbidity and diminished quality of life in many affected patients. Emerging treatments for metastatic bone disease have arisen from advances in our understanding of the unique cellular and molecular mechanisms that contribute to the bone metastasis. The tendency of cancer cells to metastasize to bone is probably the end result of many factors including vascular pathways, the highly vascular nature of the bone marrow (which increases the probability that cancer cells will be deposited in bone marrow capillaries), and molecular characteristics of the cancer cells that allow them to adapt to the bone marrow microenvironment. The goals of treating osseous metastases are manifold. Proper treatment can lead to significant improvements in pain control and function, and maintain skeletal integrity. The treatment plan requires a multidisciplinary approach. Widespread metastatic disease necessitates systemic therapy, while a localized problem is best managed with surgery, external beam radiotherapy, or both. Patients with bone metastasis can have prolonged survival, and proper management can have a significant impact on their quality of life. We will review the factors in this article that are promising molecular bone-targeted therapies or will be likely targets for future therapeutic intervention to restore bone remodeling and suppress tumor growth.
癌症转移至骨骼在患有各种恶性肿瘤的患者中很常见，并且是许多受影响患者发病和生活质量下降的主要原因。转移性骨病的新兴治疗方法源于我们对导致骨转移的独特细胞和分子机制的理解取得的进展。癌细胞转移至骨骼的倾向可能是多种因素的最终结果，包括血管途径、骨髓的高血管性质（这增加了癌细胞沉积在骨髓毛细血管中的可能性）以及使癌细胞能够适应骨髓微环境的分子特征。治疗骨转移的目标是多方面的。适当的治疗可显著改善疼痛控制和功能，并维持骨骼完整性。治疗方案需要多学科方法。广泛的转移性疾病需要全身治疗，而局部问题最好通过手术、外照射放疗或两者结合来处理。骨转移患者可以延长生存期，适当的管理对他们的生活质量会有重大影响。我们将在本文中综述那些有望成为分子骨靶向治疗或可能成为未来治疗干预靶点以恢复骨重塑和抑制肿瘤生长的因素。
