Bone Mets

Question 1

Most common site of bone metastasis:

Answer 1

Axial Skeleton:
Spine
Lumbar spine
Is the most frequent site of bone metastasis

Pelvis
Ribs

Question 2

Certain skeletal sites are associated with specific areas of bone metastases:

Scapular

Answer 2

Renal cancer

Question 3

Certain skeletal sites are associated with specific areas of bone metastases:

Skull

Answer 3

Breast

Question 4

Certain skeletal sites are associated with specific areas of bone metastases:

Distal appendicular skeleton

Answer 4

Lungs

Question 5

Certain skeletal sites are associated with specific areas of bone metastases:

Toes

Answer 5

GUT

Question 6

Normal bone

remodelling lasts around

Answer 6

100-120 days or 3-6 months

Question 7

is the area between the
epiphysis and diaphysis.
“ an area of rapidly growingtrabecular bone.

Answer 7

Metaphysis

Question 8

Most frequent site of bone metastasis
“ highest concentration in theaxial skeleton.
“ most often occurs by
hematogenous spread

Answer 8

Red bone marrow

Question 9

What primary tumors are mostly osteolytic bone mets?

Answer 9

Breast

lungs

Question 10

What primary tumors are mostly osteoblastic bone mets?

Answer 10

Thyroid

Prostate

Question 11

PURELY osteolytic?

Answer 11

Myeloma

Question 12

❖Plain radiographs is the most appropriate first imagingstudy

Disadvantage:
How many percent of the bone mineral
content must be lost before the lesion will be apparent on x-rays???

Answer 12

30-50%

Question 13

best method for screening patients at risk for bone metastasis

Answer 13

technetium 99m bone scintigraphy

Question 14

Useful in defining the extent of

cortical destruction and helping to assess the risk of a pathologic fracture

Answer 14

CT scan

Question 15

Better in assessing the

involvement of trabecular bone(red marrow), especially in the vertebral bodies

Answer 15

MRI

Question 16

c ommonl y us es t he 18-fluorodeoxyglucose (FDG) isotope

useful in detecting osteolytic bone metastases

Answer 16

PET scan

Question 17

Goals of surgical intervention:

Answer 17

Goals of surgical intervention:
to prevent or relieve pain
improve motor function
improve overall quality of life

Question 18

the sitemost likely to cause serious

morbidity.

Answer 18

Peritrochanteric femur

Question 19

Important predictors of risk of

fracture:

Answer 19

Important predictors of risk of 
fracture: 
㾎 Size of the bone metastasis 
❑ lesions ≥2.5 cm in the cortex of 
the femur were significantly more 
likely to fracture 
㾎 Proportion of cortical destruction 
◇ Risk is significantly increased 
when the destruction is >50% of 
the cortex 
㾎 Location within the bone

Question 20

Prophylactic fixation is recommended in what MIrel’s scoring system?

Answer 20

> 9

Question 21

pain relief within 48 hours
percutaneous injection of
methylmethacrylate under CT orfluoroscopic guidance

Answer 21

Vertebroplasty

Question 22

in TAX327 phase III trial

Docetaxel can: _____________

Answer 22

➢  an improvement inoverall survival 
➢  lower cancer-
induced bone pain 
➢ better objective 
tumor response

Question 23

Nitrogen-containing bisphosphonates inhibits what key enzyme in mevalonate pathway?

Answer 23

Farnesyl disphosphonate synthase

Question 24

Complications of supportive

therapy with bisphosphonates

Answer 24

osteoradionecrosis (particularly ofthe jaw)

renal insufficiency

Question 25

human monoclonalantibody specific for the RANK ligand

Answer 25

Denosumab

Question 26

``` Effective in palliating painful bone metastases partial pain relief seen in 80% to 90% of patients complete painrelief in 50% of patients ```

Answer 26

RT

Question 27

Effectiveness of Radiation Treatment depends on the GOAL:

Answer 27

``` Effectiveness of Treatment depends on the GOAL: I. Palliation of pain II. Prevention of pathologic fracture III. Avoidance of future treatments IV. Local control of the disease ```

Question 28

In Dutch trial, the response of RT on bone mets is within ____weeks

Answer 28

Responses occurred within the first 4to 6 weeks after treatment

Question 29

True or false? Single-dose treatments of 8 Gy provide similar pain relief to longer treatment regimens (30 Gy in 10 fractions or 20 to 24 Gy in five to eight treatments). The retreatment rates are higher after short course treatment by a factor of two to three.

Answer 29

TRUE

Question 30

Stereotactic Radiosurgery | The max tumor dose is:

Answer 30

12.5 to 25 Gy

Question 31

pure β-emitter | • with an energy of 1.4 MeV• half-life: 50.6 days

Answer 31

Strontium 89

Question 32

Common Primary Site for Metastases to the Bone:

Answer 32

Breast Cancer | Prostate cancer