Revista de Neumología e Investigación Clínica


Theranostic approach in lung cancer bone metastases.

Lucio Mango

Bone is the most common site of neoplastic metastasis and Non-Small Cell Lung Carcinoma (NSCLC) frequently metastasizes at the bone level, frequently in a osteolytic form. By means of bone scintigraphy, information on osteoblastic activity and skeletal perfusion is obtained. For detection of malignant bone involvement the most sensitive imaging modality is represented by 18F-fluoride PET and 18F-fluoride can be considered as a biomarker for calcium metabolism. Considering that pain is the most observed symptom, once bone metastases have been diagnosed, a therapeutic approach must be provided. After taking in account various forms of therapy (drugs based and radiotherapy), the paper considers bone seeking radionuclides as a good approach for bone metastases therapy, and taking into account the similar biological behavior between 99mTc-MDP and 18F-Fluoride PET with respect to 153Sm-ESTMP and 223Radichloride, it configures a theranostic approach to this type of treatment of bone metastases.