Differential response to external beam radiation therapy in the treatment of painful bone metastases

Endometrial cancer rarely metastasizes to bone, afflicting merely 1% of these patients. When bone metastases are present, the most common sites are the spine and hip. Metastases can result in other complications such as bone pain and compression fractures due to disruptive interactions between bone cells and tumour cells. Conventional treatment of painful bony metastases has primarily involved external beam radiation treatment (EBRT) for pain relief. We report the case of a 50-year-old female with endometrial cancer and painful bone metastases in the sternum, pelvis, and lumbar spine. After radiotherapy, she exhibited pain relief in the sternum, but indicated residual pain in the lumbar spine region. Following a percutaneous vertebroplasty (PV) procedure, significant pain relief was reported in the lower back. It is likely that this persistent pain in the lower back after EBRT was due to lumbar vertebral collapse.