Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology.

Diagnosis and treatment of bone metastasis requires various types of measures, specialists and caregivers. To provide better diagnosis and treatment, a multidisciplinary team approach is required. The members of this multidisciplinary team include doctors of primary cancers, radiologists, pathologists, orthopaedists, radiotherapists, clinical oncologists, palliative caregivers, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, occupational therapists, medical social workers, etc. Medical evidence was extracted from published articles describing meta-analyses or randomised controlled trials concerning patients with bone metastases mainly from 2003 to 2013, and a guideline was developed according to the Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Multidisciplinary team meetings are helpful in diagnosis and treatment. Clinical benefits such as physical or psychological palliation obtained using the multidisciplinary team approaches are apparent. We established a guideline describing each specialty field, to improve understanding of the different fields among the specialists, who can further provide appropriate treatment, and to improve patients' outcomes.
Competing Interests: S Kato, sponsored research (Chugai Pharmaceutical Co, Ltd); IO, honoraria (Taiho Pharmaceutical Co, Ltd); S Kinuya, data and safety monitoring board (Bayer Yakuhin, Ltd); NS, honoraria (Novartis Pharma); ST, honoraria (Astellas Pharma Inc, AstraZeneca plc, Daiichi Sankyo Co, Ltd, Novartis Pharma), sponsored research (Sanofi, Zenyaku Kogyo Co, Ltd, Taiho Pharmaceutical Co, Ltd, Boehringer Ingelheim Japan, Chugai Pharmaceutical Co, Ltd, Novartis Pharma); YT, honoraria (Janssen Pharma); K Takayama20, consultation and honoraria (Clinical Research Support Center Kyushu, AstraZeneca plc, Chugai Pharmaceutical Co, Ltd, Eli Lilly Japan, PfizerJapan Inc), sponsored research (Kyowa Hakko Kirin Co, Ltd, plc, Daiichi Sankyo Co, Ltd, Chugai Pharmaceutical Co, Ltd, Eli Lilly Japan, Novartis Pharma, Bristol-Myers Squibb); UT, consultation and honoraria (Micron Inc, SymBio Pharmaceutical Co, Ltd, Chugai Pharmaceutical Co, Ltd, Nihon Medi-Physics Co, Ltd); HM, sponsored research (Eisai Co, Ltd, Taiho Pharmaceutical Co, Ltd); T Yuasa, honoraria (Novartis Pharma, PfizerJapan Inc).