Skeletal complications in patients with CRPC

Abstract

Skeletal complications in patients with prostate cancer can result in significant morbidity. There is a relatively high prevalence of bone metastasis and reduction of bone mineral density due to androgen deprivation therapy, and together, these can result in the development of multiple skeletal complications in patients with prostate cancer. The relatively long survival (median, 3-4 years) after bone metastases with multiple skeletal complications makes a significant negative impact on patients' functional status, quality of life, and social resource utilization. To evaluate skeletal complications, the term "skeletal-related events (SREs)" has frequently been used in most randomized trials conducted previously. SREs usually include pathological bone fracture, spinal cord compression, surgery to bone, and radiotherapy to the bone. Recently, symptomatic skeletal events (SSEs), including only symptomatic events, is the recommended term for use in clinical trials. Local therapies for skeletal complications, such as radiation and surgery, are usually performed to reduce local symptoms, such as bone pain or neurological deficits, leading to improvement of the health-related quality of life. Systemic therapies, such as radiopharmaceuticals, bisphosphonates, and monoclonal antibodies against the receptor activator of the nuclear factor-kappa B ligand, are administered to reduce presymptomatic and symptomatic skeletal complications.