Bone flare reaction as a sign of response to antineoplastic treatment has been redefined, including the onset of new osteoblastic lesions. If misunderstood as skeletal progression, this finding could lead to erroneous therapy discontinuation, changing the disease clinical course. We aim to describe this clinical phenomenon in patients with advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (
We retrospectively reviewed the computed tomography scans of 43
Osteoblastic reaction was detected in 10 cases (23%), showing different patterns: dimensional or density increase of known osteosclerotic metastases (pattern A, n = 4); response of previously lytic lesions (pattern B, n = 2); onset of new osteosclerotic lesions (pattern C, n = 4). Seven patients had partial response to TKI treatment, with response rate of 70%, vs 50% of patients with bone metastases without this reaction. No difference in terms of median overall survival or progression-free survival emerged between patients with or without osteoblastic reaction.
The correct clinico-radiologic interpretation of osteoblastic reaction is crucial to avoid waste of therapeutic lines when TKI treatment has not yet exhausted its potential effectiveness. Clinical implications of ambiguous radiologic findings as described in this study deserve further discussion.
Tumori 2017; 103(1): 66 - 71
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsMelissa Bersanelli, Paola Bini, Enrico Rabaiotti, Francesco Facchinetti, Massimo De Filippo, Beatrice Bortesi, Sebastiano Buti, Marcello Tiseo
- • Accepted on 30/06/2015
- • Published online on 19/09/2015
- • Available online on 19/09/2015
- • Published in print on 21/01/2017
This article is available as full text PDF.
- Bersanelli, Melissa [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Bini, Paola [PubMed] [Google Scholar] 2
- Rabaiotti, Enrico [PubMed] [Google Scholar] 2
- Facchinetti, Francesco [PubMed] [Google Scholar] 1
- De Filippo, Massimo [PubMed] [Google Scholar] 2
- Bortesi, Beatrice [PubMed] [Google Scholar] 1
- Buti, Sebastiano [PubMed] [Google Scholar] 1
- Tiseo, Marcello [PubMed] [Google Scholar] 1
Medical Oncology Unit, University Hospital of Parma, Parma - Italy
Radiology Unit, University Hospital of Parma, Parma - Italy