Heidenreich Axel
Department of Urology, Philipp University Marburg, Marburg, Germany.
Oncology. 2003;65 Suppl 1:5-11. doi: 10.1159/000072485.
Prostate cancer (PCA) frequently metastasizes to the bones, and skeletal metastases represent the most common cause of morbidity in advanced PCA. Besides the development of skeletal events due to metastases, patients with PCA are at higher risk for benign osseous complications, such as osteoporosis and fractures. Bisphosphonates (BPs) have emerged as an integral part of the management of skeletal disease related to PCA. Currently available data support their routine use to prevent androgen-deprivation-induced osteoporosis and its secondary complications. Dosing at 3-month intervals is appropriate; further studies will have to demonstrate the efficacy of annual dosing. In men with already established bone metastases, BPs might be helpful in preventing skeletal-related events in patients who do not respond to alternative therapies and are at high risk for bone fractures or spinal cord compression. In patients with hormone-refractory prostate cancer, BPs might be administered for analgesic purposes. Prospective randomized trials will have to explore the clinical role of BPs in the prevention of bone metastases following local therapy with curative intent in men at high risk for PCA recurrences.
前列腺癌（PCA）常转移至骨骼，骨转移是晚期PCA患者发病的最常见原因。除了转移导致的骨相关事件外，PCA患者发生骨质疏松和骨折等良性骨并发症的风险更高。双膦酸盐（BPs）已成为PCA相关骨疾病治疗不可或缺的一部分。现有数据支持其常规用于预防雄激素剥夺所致骨质疏松及其继发并发症。每3个月给药一次是合适的；进一步研究将需证明每年给药一次的疗效。在已有骨转移的男性患者中，对于那些对其他治疗无反应且有骨折或脊髓压迫高风险的患者，BPs可能有助于预防骨相关事件。在激素难治性前列腺癌患者中，BPs可用于止痛。前瞻性随机试验将需探索BPs在具有PCA复发高风险男性患者进行根治性局部治疗后预防骨转移方面的临床作用。
