Nursing care for patients with bone metastases undergoing radiotherapy: a scoping review

Keywords: Nursing Care; Neoplasm Metastasis; Bone and Bones; Radiotherapy.


Objective: to map studies on nursing care for patients with bone metastases undergoing radiotherapy. Methods: scoping review conducted in nine databases, according to the guidelines of the Joanna Briggs Institute. Scientific articles available for full open access, in any language, regardless of the method used, were included. Results: 13 studies were analyzed, with a predominance of literature reviews. The themes were: health education to patients and companions about events related to the skeleton; pain assessment and management; prevention of pathological fractures; management of spinal cord compression; assessment of hypercalcemia; ensuring safety in the administration of oral bisphosphonates; quality of life assessment; and monitoring of progress, adverse events, and therapeutic outcomes. Conclusion: nurses provide important ongoing support to patients, monitor progress, side effects, and therapeutic outcomes, and prevent and manage skeletal-related events. Contributions to practice: the study highlighted the main nursing care to patients with bone metastases in radiotherapy treatment, being relevant to give theoretical subsidy to professionals directing their assistance, especially in the oncology area.


Fares J, Fares MY, Khachfe HH, Salhab HA, Fares Y. Molecular principles of metastasis: a hallmark of cancer revisited. Signal Transduct Target Ther. 2020;5(1):28. doi:

Vičić I, Belev B. The pathogenesis of bone metastasis in solid tumors: a review. Croat Med J. 2021;62(3):270-82. doi:

Hiraga T. Bone metastasis: Interaction between cancer cells and bone microenvironment. J Oral Biosci. 2019;61(2):95-8. doi:

Drudge-Coates L, Muilekom E, Torre-Montero JC, Leonard K, Oostwaard M, Niepel D. et al Management of bone health in patients with cancer: a survey of specialist nurses. Support Care Cancer. 2020;28(3):1151-62. doi:

Ma X, Yu J. Role of the bone microenvironment in bone metastasis of malignant tumors - therapeutic implications. Cell Oncol (Dordr). 2020;43(5):751-61. doi:

Tan H, Wang F, Ni M, Liu F, Wu P. Pain care nursing ameliorates the psychological burden and improves the efficacy in combined treatment of radiotherapy and zoledronic acid for bone metastasis of malignant tumor. Int J Clin Exp Med [Internet]. 2019 [cited Dec. 20, 2022];12(7):8985‐91. Available from:

Saldanha ZO, Sá AMM, Santos MNA, Santana ME. O cuidado de enfermagem para a mulher que vivencia câncer de mama com metástase óssea. Enferm Foco. 2020;11(5):34-9. doi:

Rapeaud E, Meynard C, Lecante F, Durdux C. Métastases osseuses: efficacité et modalités de prescription de la radiothérapie classique. Cancer Radiother. 2021;25(6-7):707-12. doi:

Aielli F, Ponzetti M, Rucci N. Bone metastasis pain, from the bench to the bedside. Int J Mol Sci. 2019;20(2):280. doi:

Pituskin E, Sneath S, Rabel H, O’Rourke T, Duggleby W, Hunter K, et al. Addressing pain associated with bone metastases: oncology nursing roles in a multidisciplinary rapid-access palliative radiotherapy clinic. Semin Oncol Nurs. 2022;38(2):151279. doi:

Cinar D, Yesilbalkan OU, Yildirim Y, Pamuk A. Examining pain and performance status of radiotherapy cancer patients with bone metastasis. Int J Caring Sci [Internet]. 2018 [cited Dec. 18, 2022];11(2):1083-94. Available from: ginal_10_2.pdf

Munn Z, Pollock D, Khalil H, Alexander L, Mclnerney P, Godfrey CM, et al. What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evid Synt. 2022;20(4):950-2. doi:

Lockwood C, Santos KB, Pap R. Practical guidance for knowledge synthesis: scoping review methods. Asian Nurs Res. 2019;13(5):287-94.doi:

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D Tricco, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-73. doi:

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71. doi:

Fitch M, Maxwell C, Ryan C, Löthman H, Drudge-Coates L, Costa L. Bone metastases from advanced cancers: clinical implications and treatment options. Clin J Oncol Nurs. 2009;13(6):701-10. doi:

Beaumont T, Leadbeater M. Treatment and care of patients with metastatic breast cancer. Nurs Stand. 2011;25(40):49-56. doi:

Fitch MI. Supportive care needs of patients with advanced disease undergoing radiotherapy for symptom control. Can Oncol Nurs J. 2012;22(2):84-100. doi:

Farrell C. Bone metastases: assessment, management and treatment options. Br J Nurs. 2013;22(10):4-11. doi:

Campbell-Baird C, Harrelson S, Frey G, Balakumaran A. Clinical efficacy of denosumab versus bisphosphonates for the prevention of bone complications: implications for nursing. Support Care Cancer. 2015;23(12):3625-32. doi:

Sharma N, Purkayastha A. Follicular thyroid carcinoma presenting as large solitary vertebral metastasis: report of two unusual cases treated with radiotherapy. Asia Pac J Oncol Nurs. 2017;4(3):269-72. doi:

Geerling J, Van Der Linden Y, Mul V, Nijs E, Oudhof M, Raijmakers N, et al. Pain education of patients with painful bone metastases reduces pain; a multicentre randomised trial. Radiother Oncol [Internet]. 2018 [cited Dec. 18, 2022];127. Available from:

Serçe S, Ovayolu Ö, Pirbudak L, Ovayolu N. The effect of acupressure on pain in cancer patients with bone metastasis: a nonrandomized controlled trial. Integr Cancer Ther. 2018;17(3):728-36. doi:

Pituskin E, Fairchild A. Prostate cancer with bone metastases: addressing chronic pain from the perspective of the radiation oncology nurse practitioner. Semin Oncol Nurs. 2021;37(4):151175. doi:

How to Cite
Sagica, T. dos P., Oliveira, S. S. S. de, Pereira, O. V., & Ramos, A. M. P. C. (2023). Nursing care for patients with bone metastases undergoing radiotherapy: a scoping review. Rev Rene, 24, e81537.
Review Article