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[前列腺癌骨转移的放射治疗与双膦酸盐治疗]

[Radiotherapy and bisphosphonate therapy in bone metastases of prostate carcinoma].

作者信息

Seegenschmiedt M H, Oppenkowski R

机构信息

Klinik für Radioonkologie, Strahlentherapie & Nuklearmedizin, Alfried Krupp von Bohlen und Halbach Krankenhaus, Essen, Deutschland.

出版信息

Praxis (Bern 1994). 2001 Sep 20;90(38):1645-52.

Abstract

Prostate carcinoma patients with bone metastases do not have a dismal prognosis or short life expectancy by itself. Thus, often palliative therapeutic measures are required with respect of a life span beyond one year, especially if no lyphogenic or visceral metastases have developed. Similarly to patients with breast carcinoma the metastatic bone lesions in prostate carcinoma patients have mixed osteolytic and osteoblastic features with increased metabolic bone turn-over. This is the mechanism, in which bisphosphonates interfere and can prevent the pathologic bone resorption by blocking osteoclast activity. This improves not only painful clinical conditions but also reduces the rate of skeletal related events (SRE = hypercalcemia, bone fracture, myelon compression, surgery or radiotherapy to bone etc.). Generally, clinical studies suggest the benefit of bisphosphonates for patients with bone metastases and good life expectancy. For patients with prostate carcinoma large controlled studies have to consolidate this potential benefit.

摘要

患有骨转移的前列腺癌患者本身预后并不差,预期寿命也不短。因此,对于生存期超过一年的患者,通常需要采取姑息性治疗措施,尤其是在没有发生淋巴或内脏转移的情况下。与乳腺癌患者类似,前列腺癌患者的转移性骨病变具有溶骨性和成骨性混合特征,骨代谢转换增加。这就是双膦酸盐发挥作用的机制,它通过阻断破骨细胞活性来干扰并预防病理性骨吸收。这不仅改善了疼痛的临床症状,还降低了骨相关事件(SRE = 高钙血症、骨折、脊髓压迫、骨手术或放疗等)的发生率。一般来说,临床研究表明双膦酸盐对有骨转移且预期寿命良好的患者有益。对于前列腺癌患者,需要大型对照研究来巩固这种潜在益处。

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