![]() ![]() ![]() Tables with predefined PICO questions were used (Supplementary Table 1). Radium-223 is included, although the detailed analysis is presented in separate guidelines. To ensure high-quality, independent data search, a third party (the German Agency for Quality in Medicine, Germany) searched Medline via PubMed ( ) and the Cochrane Library databases ( ) to systematically locate and obtain the articles relevant to clinically used bone-seeking radiopharmaceuticals (including alpha and beta emitters for both mentioned guidelines) in metastatic bone disease (samarium-153, strontium-89, phosphorus-32, rhenium-188, radium-223) published between 20. These guidelines are a revised version of the previously published EANM procedure guidelines on the treatment of painful bone metastases. Not only has radionuclide therapy with alpha-emitting radionuclides (radium-223) been used to treat bone metastasis-related pain, but it has also recently been demonstrated to prolong patient survival. Substantial advantages of bone radionuclide therapy include its ability to simultaneously treat multiple sites of disease, ease of administration, repeatability and potential integration with the other treatments. Treatment of cancer-induced bone pain normally progresses through the sequence: nonsteroidal analgesics to opioids often combined with radiotherapy, surgery, chemotherapy, hormone treatment, bisphosphonates and radionuclide therapy. The spine, pelvis and ribs are often the earliest site of metastases, but most bone metastases (more than 80%) are found in the axial skeleton. It has been reported that up to 90% of patients with metastatic or advanced cancer will experience significant cancer-related pain and the majority of them will experience bone pain. Pain is a major healthcare problem in patients with bone metastases. Breast, prostate and lung cancers are collectively responsible for about 80% of secondary metastatic bone disease. Metastatic bone disease is a common and severe complication of several types of advanced disease. The sole purpose of these guidelines is to assist practitioners in achieving this objective. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources and the needs of the patient to deliver effective and safe medical care. Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. The practice of medicine involves not only the science but also the art of dealing with the prevention, diagnosis, alleviation and treatment of disease. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set out in the guidelines when, in the reasonable judgement of the practitioner, such a course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. The ultimate judgement regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. They are not inflexible rules or requirements for practice and are not intended, nor should they be used, to establish a legal standard of care. These guidelines are intended to assist practitioners in providing appropriate nuclear medicine care for patients. The EANM has written and approved these guidelines to promote the use of nuclear medicine procedures of high quality. The EANM recognizes that the safe and effective use of diagnostic nuclear medicine imaging requires specific training, skills, and techniques, as described in each document. The practice guidelines on each topic, that represent policy statements by the EANM, have undergone a thorough consensus process during which they have been extensively reviewed. Existing practice guidelines are reviewed for revision or renewal as appropriate on their fifth anniversary or sooner if indicated. The EANM periodically releases new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients throughout Europe. EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |