Ramaswamy Bhuvaneswari, Shapiro Charles L
Ohio State University Medical Center, Comprehensive Cancer Center, Columbus, Ohio, USA.
Oncology (Williston Park). 2003 Sep;17(9):1261-70; discussion 1270-2, 1277-8, 1280.
Bisphosphonates have an established role in treating tumor-induced hypercalcemia and decreasing the incidence of skeletal-related events. Recent data suggest that these agents may also prevent skeletal metastases. This review explains how cancer metastasizes to bone and how bisphosphonates may block this process, with a summary of clinical trials supporting the use of bisphosphonates to treat and prevent bone metastases. For skeletal metastases in patients with breast cancer, multiple myeloma, or other solid tumors, bisphosphonates are important adjuncts to systemic therapy. Despite promising results in metastatic prostate cancer, additional trials are needed before bisphosphonates become part of standard treatment in this setting. Ongoing trials are evaluating the preventive role of the third-generation bisphosphonates in breast cancer patients. Until the results of these trials are presented, bisphosphonates should only become a component of adjuvant treatment in the context of a clinical trial. Bone loss, a common consequence of cancer treatment, should be treated with the usual measures indicated for the management of osteoporosis, including bisphosphonates.
双膦酸盐在治疗肿瘤引起的高钙血症以及降低骨相关事件的发生率方面已确立了其作用。近期数据表明，这些药物可能还能预防骨转移。这篇综述解释了癌症如何转移至骨骼以及双膦酸盐如何可能阻断这一过程，并总结了支持使用双膦酸盐治疗和预防骨转移的临床试验。对于乳腺癌、多发性骨髓瘤或其他实体瘤患者的骨转移，双膦酸盐是全身治疗的重要辅助药物。尽管在转移性前列腺癌方面取得了令人鼓舞的结果，但在双膦酸盐成为这种情况下的标准治疗组成部分之前，还需要进行更多试验。正在进行的试验正在评估第三代双膦酸盐在乳腺癌患者中的预防作用。在这些试验结果公布之前，双膦酸盐仅应在临床试验的背景下成为辅助治疗的一个组成部分。骨质流失是癌症治疗的常见后果，应采用治疗骨质疏松症的常用措施进行治疗，包括使用双膦酸盐。
