The treatment of osseous metastases of hormone-refractory prostate cancer with external beam radiotherapy and Strontium-89.

Metastatic bone disease from hormone-refractory prostate cancer can lead to significant morbidity such as pain, nerve compression and fractures which diminishes the quality of life of these patients substantially. Pain from osteoblastic metastases can significantly be improved by both external radiotherapy and Strontium-89 (89Sr), whereas lytic metastases are only responsive to external irradiation. Pain relief is obtained in approximately 80% of patients. Toxicity is mild and retreatment is usually possible. External beam radiotherapy is indicated when spinal cord or nerve root compression is demonstrated, or when osteolytic metastases with danger of fracture are visualized. External radiotherapy and Strontium-89 are important treatments to palliate patients suffering from metastatic prostate cancer. Because of their mild toxicity and highly effective analgesic effect, implementation of irradiation and 89Sr should be start of early in the disease process of these patients in order to keep them ambulatory and pain-free as long as possible.