Rosen Lee, Harland Stephen J, Oosterlinck Willem
John Wayne Cancer Institute, 2001 Santa Monica Blvd., Suite 560W. Santa Monica, CA 90404, USA.
Am J Clin Oncol. 2002 Dec;25(6 Suppl 1):S19-24. doi: 10.1097/00000421-200212001-00004.
Bone metastases are a common feature of a variety of solid tumors and are associated with substantial skeletal morbidity, including severe bone pain and pathologic fractures. Treatment with bisphosphonates, primarily pamidronate, is the current standard of care for patients with breast cancer and multiple myeloma who have predominantly osteolytic lesions. However, until recently no bisphosphonate had demonstrated efficacy in patients with osteoblastic lesions, which are common during the progression of prostate cancer and other solid tumors. Zoledronic acid, a potent, new-generation, nitrogen-containing bisphosphonate, has demonstrated significant benefits for patients with bone metastases resulting from a broad range of primary tumors, including multiple myeloma and breast, lung, kidney, and prostate cancers, and other solid tumors. Benefits include a decreased incidence of pathologic fractures and longer time to the first skeletal complication. Zoledronic acid is the first and only bisphosphonate to be proved effective in patients with all types of bone lesions, from osteolytic to osteoblastic, and therefore represents an important therapeutic advancement in the treatment of bone metastases.
骨转移是多种实体瘤的常见特征，与严重的骨骼病变相关，包括严重骨痛和病理性骨折。双膦酸盐类药物，主要是帕米膦酸，是目前对主要为溶骨性病变的乳腺癌和多发性骨髓瘤患者的标准治疗方法。然而，直到最近，还没有双膦酸盐类药物在成骨性病变患者中显示出疗效，而成骨性病变在前列腺癌和其他实体瘤进展过程中很常见。唑来膦酸是一种强效的新一代含氮双膦酸盐，已证明对多种原发性肿瘤导致的骨转移患者有显著益处，这些原发性肿瘤包括多发性骨髓瘤以及乳腺癌、肺癌、肾癌和前列腺癌等其他实体瘤。益处包括病理性骨折发生率降低以及首次发生骨骼并发症的时间延长。唑来膦酸是首个也是唯一被证明对所有类型骨病变（从溶骨性到成骨性）患者均有效的双膦酸盐类药物，因此代表了骨转移治疗方面的一项重要治疗进展。
