Depending on the type of tumor, radiation therapy (radiotherapy, radiatio) – with curative (curative) as well as palliative (disease-moderating) intent – may be used, possibly in combination with surgery:
- In the therapy of metastases (daughter tumors) of radiation-sensitive primary tumors such as lymphomas, prostate tumors, or germ cell tumors, radiation therapy is of great importance [standard therapy: both for analgesia (abolition of pain sensation), relapse prevention (prevention of recurrence of the disease), and recalcification/increased absorption of calcium into the tissue to restore normal calcium levels]. Furthermore, the administration of bisphosphonates or the monoclonal antibody denosumab (mimics in bone metabolism the effects of osteoprotegerin, OPG).
- Ewing sarcoma group: treatment of the primary tumor is by surgery, radiotherapy, or a combination of both procedures.
- Chordomas and chondrosarcomas (here: proton therapy).
Further notes
- Vertebral metastases (daughter tumors in the spine): a randomized trial provided evidence that radiotherapy was able to maintain or restore walking ability in most tumor patients with vertebral metastases in the last weeks of life. Usually, patients receive 20 grays divided into 5 partial irradiations of 4 grays each (= sequential irradiation). In the present study it could be shown that a single irradiation with 8 Gray already showed good results: after the single irradiation 115 of 166 patients (69.3 %) were able to walk without assistance; after the sequential irradiation 128 of 176 patients (72.7 %) were able to walk. Thus, the noninferiority of single irradiation could not be proven, but patients were spared an entire week of irradiation appointments.However, patients with metastases in the lower spine should receive multiple irradiation because it is more likely to restore bladder function.
