Palliative Management of Metastatic Bone Disease

Metastatic Bone Disease (MBD) is the most common primary malignant bone tumor, predominantly affecting adolescents and young adults. Advances in therapeutic strategies, including neoadjuvant chemotherapy, surgery, and limb reconstruction, have significantly improved the 5-year survival rate for non-metastatic cases to 60–70%, compared to historical rates of only 10–20%. Key prognostic factors include histological response to preoperative chemotherapy, alkaline phosphatase levels, and lactate dehydrogenase. However, prognosis remains poor for patients with metastases, particularly pulmonary metastases, or tumors located in the pelvis and axial skeleton. Data from Indonesia reveal relatively low survival rates, with a mean survival of only 28 months, indicating limited access to optimal treatment. Recent research developments, such as gene therapy, immunotherapy, and advanced reconstructive techniques, hold promises for improving therapeutic outcomes and patient quality of life in the future. Keywords: MBD, neoadjuvant chemotherapy, prognosis, limb reconstruction, gene therapy.