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Hematol Oncol Clin North Am. 2018 Jun;32(3):447-458. doi: 10.1016/j.hoc.2018.01.006. Epub 2018 Mar 22.

Mechanisms of, and Adjuvants for, Bone Pain.

Author information

1
Department of Radiation Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA. Electronic address: nicholas.figura@moffitt.org.
2
Department of Supportive Care Medicine, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
3
Department of Radiation Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.

Abstract

Metastatic bone pain is a complex, poorly understood process. Understanding the unique mechanisms causing cancer-induced bone pain may lead to potential therapeutic targets. This article discusses the effects of osteoclast overstimulation within the tumor microenvironment; the role of inflammatory factors at the tumor-nociceptor interface; the development of structural instability, causing mechanical nerve damage; and, ultimately, the neuroplastic changes in the setting of sustained pain. Several adjuvant therapies are available to attenuate metastatic bone pain. This article discusses the role of pharmacologic therapies, surgery, kyphoplasty, vertebroplasty, and radiofrequency ablation.

KEYWORDS:

Bisphosphonate; Bone; Kyphoplasty; Metastatic; NGF; Pain; RANKL inhibitor; Vertebroplasty

PMID:
29729780
DOI:
10.1016/j.hoc.2018.01.006
[Indexed for MEDLINE]

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