Neri B, Gemelli M T, Sambataro S, Colombi L, Benvenuti F, Ludovici M, Pacini P
Day-Hospital Oncologico, Istituto di Clinica Medica IV, Firenze, Italy.
Anticancer Drugs. 1992 Apr;3(2):87-90. doi: 10.1097/00001813-199204000-00002.
Twenty postmenopausal women (aged between 46 and 67 years old) with skeletal metastases from breast carcinoma were treated with clodronate 450 mg i.v. daily for 5 days and thereafter with 100 mg i.m. daily for 10 days. All patients received standard hormonal therapy (tamoxifen). Symptomatic pain (evaluated according to a linear analog scale), performance status (according to Karnofsky), serum alkaline phosphatase, serum creatinine and osteocalcin were measured before and after treatment on days 5, 15, 30 and 45. Scanning by radiology were performed pre- and post-therapy. Bone pain was significantly reduced in 15 out of 20 patients. After clodronate treatment the base line value of circulating osteocalcin (3.2 +/- 1.6 ng/ml) showed a significant increase on days 30 and 45 (p less than 0.001). Radiological assessment of bone lesions showed stable disease in 18 patients and progression in two patients. No adverse side effects were observed. These data show that clodronate provided pain relief in 75% of treated patients and the increase in circulating osteocalcin levels can be considered a marker of the stabilization of skeletal metastatic lesions.
20名患有乳腺癌骨转移的绝经后女性（年龄在46至67岁之间）接受了氯膦酸盐治疗，静脉注射450毫克，每日1次，共5天，之后肌肉注射100毫克，每日1次，共10天。所有患者均接受标准激素治疗（他莫昔芬）。在治疗前以及治疗后第5天、15天、30天和45天测量症状性疼痛（根据线性模拟量表评估）、体能状态（根据卡诺夫斯基量表）、血清碱性磷酸酶、血清肌酐和骨钙素。治疗前后均进行放射学扫描。20名患者中有15名骨痛明显减轻。氯膦酸盐治疗后，循环骨钙素的基线值（3.2±1.6纳克/毫升）在第30天和第45天显著升高（p<0.001）。骨病变的放射学评估显示，18名患者病情稳定，2名患者病情进展。未观察到不良副作用。这些数据表明，氯膦酸盐使75%的接受治疗患者的疼痛得到缓解，循环骨钙素水平的升高可被视为骨骼转移病变稳定的一个标志。
