**7. Conclusion**

Treatment with bone seeking radiopharmaceuticals in patients with multiple painful skeletal metastases is safe and effective when proper protocols are being used. Important improvements may be found in multimodality treatment in long-term treatment regimens and in individualized patient management. Identification of powerful indicators of toxicity and efficacy may guide patient selection and therapy monitoring to optimize the patient's outcome. This may possibly lead us beyond pain palliation towards improvement of survival.
