Bone metastasis from cervical cancer.

BACKGROUND: This retrospective analysis examines the frequency, distribution, and the pattern of disease progression of bone metastasis in patients treated for cervical cancer and the use and results of palliative intent radiation therapy. METHODS: Charts, films, and other available records were reviewed for the 41 patients with bone metastasis of the 496 patients with invasive cervical cancer treated at the Gershenson Radiation Oncology Center, Detroit, Michigan, from 1980 through 1989. RESULTS: Several patterns of bone metastasis were observed: (1) direct extension into bone from the parametrial extensions of the primary or recurrent pelvic tumor, (2) direct extension into bone from parenchymal metastasis to distant lymph nodes or lung, (3) regional hematogenous metastasis compatible with Batson's venous plexus distribution, and (4) systemic hematogenous metastasis to distant bones. Eighty percent of the patients were irradiated, and of those, 70% experienced pain relief. CONCLUSIONS: Bone metastasis in patients with cervical cancer is an infrequent but significant occurrence with associated severe dysfunction, other signs of local and distant failure, and short life expectancy. Radiation therapy provides moderate palliation for treatable patients.

Eye metastasis from carcinoma of the breast: diagnosis, radiation treatment and results.

The experience at the Gershenson Radiation Oncology Center of 32 cases of metastases to the eye or orbit from breast cancer are presented with a review of the literature. The 32 patients were referred for radiation therapy in the period of 1980-1991. Eighteen patients had metastasis to the choroid, 2 patients had involvement of other parts of the eye (anterior chamber +/- choroid), and 11 patients had orbital metastasis. In one patient, the diffuse nature of the disease prevents subsite assignment. Ten of the patients with eye metastases also had brain or meningeal metastases (8 patients concurrent with eye metastases). Four of the 32 patients had bilateral choroidal metastases. A complete course of radiation therapy was delivered to 28 patients, one patient was not treated and 3 patients received only partial treatment because of general deterioration due to other widespread metastases from breast cancer. Of 21 evaluable patients, 15 had definite improvement. There was no progression of the eye metastases in the other 6 patients. The rest (7 patients) were lost to detailed follow-up of the response of the eye metastases. Four patients are still alive without any severe long-term side-effects. The diagnosis, treatment and outcome is presented with a review of the literature. The importance of emergency treatment for rapidly progressing lesions is stressed as well as the need for detailed treatment planning, careful delivery of daily treatments with a high degree of reproducibility and precision to prevent possible damage to sensitive normal structures.