Elomaa I, Kylmälä T, Tammela T, Viitanen J, Ottelin J, Ruutu M, Jauhiainen K, Ala-Opas M, Roos L, Seppänen J
Department of Radiotherapy and Oncology, University of Helsinki, Finland.
Int Urol Nephrol. 1992;24(2):159-66. doi: 10.1007/BF02549644.
Although osteosclerotic metastases are characteristic of prostatic carcinoma, bone resorption is also accelerated. Since clodronate inhibits bone resorption and relieves bone pain, we have given it to patients with painful bone disease from prostatic cancer after failure of hormonal therapy. All patients received estramustine phosphate orally. Simultaneously they were randomly allocated to clodronate (36) and placebo (39) groups. Clodronate was given by mouth. The dose was 3.2 g for the first month, thereafter 1.6 g. Pain relief was more distinct in the clodronate group where one third of patients were totally free of bone pain. The use of analgesics stopped in 38% of patients on clodronate and in 18% on placebo which effect probably belongs to estramustine phosphate. Serum calcium concentration decreased more markedly in the clodronate group. Clodronate dose of 3.2 g seemed to be more potent than that of 1.6 g. Side effects were uncommon and occurred equally in both groups. No significant differences were seen in median survival or survival rates between the groups.
尽管骨硬化性转移是前列腺癌的特征，但骨吸收也会加速。由于氯膦酸盐可抑制骨吸收并缓解骨痛，我们在激素治疗失败后，将其给予患有前列腺癌引起的疼痛性骨病的患者。所有患者均口服磷酸雌莫司汀。同时，他们被随机分为氯膦酸盐组（36例）和安慰剂组（39例）。氯膦酸盐通过口服给药。第一个月的剂量为3.2克，此后为1.6克。氯膦酸盐组的疼痛缓解更为明显，其中三分之一的患者完全没有骨痛。服用氯膦酸盐的患者中有38%停止使用镇痛药，服用安慰剂的患者中有18%停止使用，这种效果可能归因于磷酸雌莫司汀。氯膦酸盐组的血清钙浓度下降更为明显。3.2克的氯膦酸盐剂量似乎比1.6克的更有效。副作用并不常见，两组发生率相同。两组之间的中位生存期或生存率没有显著差异。
