Body Jean-Jacques
Supportive Care Clinic and Clinic of Endocrinlogy and Bone Disease, Université Libre de Bruxelles, Belgium.
Semin Nephrol. 2004 Jan;24(1):48-54. doi: 10.1053/j.semnephrol.2003.08.015.
Less than 25 years ago tumor-induced hypercalcemia was often a lethal complication of cancer. Nowadays, it can be treated easily and successfully in at least 90% of cases by volume repletion in addition to the use of bisphosphonates that are potent anti-osteoclastic compounds. The standard therapy consists of the administration of 90 mg pamidronate or, more recently, 4 mg zoledronic acid, a more efficient bisphosphonate. When available, another alternative bisphosphonate is ibandronate. Recurrent hypercalcemia is nevertheless difficult to control and antibodies against parathyroid hormone-related protein could be useful for that matter in selected patients who are not in the terminal stage of their disease. Prevention of tumor-induced hypercalcemia is one of the objectives of long-term therapy with bisphosphonates in patients with tumor bone disease. The use of bisphosphonates in placebo-controlled trials has shown that the incidence of hypercalcemic episodes is reduced by more than one half.
不到25年前，肿瘤引起的高钙血症常常是癌症的致命并发症。如今，除了使用强效抗破骨细胞化合物双膦酸盐外，通过补充血容量，至少90%的病例可以轻松且成功地得到治疗。标准治疗方案包括给予90毫克帕米膦酸盐，或者最近使用4毫克唑来膦酸，后者是一种更有效的双膦酸盐。如有条件，另一种可供选择的双膦酸盐是伊班膦酸盐。然而，复发性高钙血症难以控制，对于那些尚未处于疾病终末期的特定患者，抗甲状旁腺激素相关蛋白抗体在这方面可能会有用。预防肿瘤引起的高钙血症是肿瘤骨病患者长期使用双膦酸盐治疗的目标之一。在安慰剂对照试验中使用双膦酸盐已表明，高钙血症发作的发生率降低了一半以上。
