17
Good Practice Statement 15
➤ Patients with brain metastases may be expected to be at increased
risk if operating motor vehicles or if placed in a situation in which
they may jeopardize themselves or others and therefore should be
appropriately counseled. (GPS)
Approaches to Bone Metastases
Recommendation 29
➤ In patients with ATC with symptomatic or threatening bone
metastases—but without structural compromise or threatened
spinal cord compression in need of surgical remediation—the ATA
recommends palliative radiotherapy. (S-L)
Recommendation 30
➤ In patients with ATC with bone metastasis causing structural
compromise in a weight-bearing region or threatening spinal cord
compression, the ATA recommends orthopedic fixation before
initiation of palliative radiotherapy. (S-L)
Recommendation 31
➤ In patients with ATC with bone metastasis, the ATA suggests periodic
intravenous bisphosphonate infusions or subcutaneous RANK ligand
inhibitor. (C-L)
Good Practice Statement 16
➤ In patients on systemic therapy who develop oligo-progressive
disease, local tumor-directed therapy may be considered to postpone
the need to change otherwise beneficial systemic therapy. (GPS)
Approaches to Other Sites of Metastases
➤ Systemic therapy as described above is the first line of treatment, but
if a particular metastasis is symptomatic or has progressed despite
systemic therapy, treatment may be individualized to metastatic
locations, much as would be the case for other malignancies. (N)
Approaches to Oligoprogressive Metastatic Disease
Good Practice Statement 11
➤ In patients on systemic therapy who develop oligo-progressive
disease, local tumor-directed therapy may be considered to postpone
the need to change otherwise beneficial systemic therapy. (GPS)
