Saba Nabil, Khuri Fadlo
Winship Cancer Institute, Emory University, Atlanta, Ga., USA.
Oncology. 2005;68(1):10-7. doi: 10.1159/000084517. Epub 2004 Mar 15.
With recent advances in cancer management, patients with metastatic bone disease are likely to have a prolonged clinical course, with skeletal-related events such as pain, hypercalcemia, pathologic fractures, spinal cord and nerve compression. Bisphosphonate use has resulted in the reduction of skeletal-related complications for a number of tumors including breast, prostate and myeloma, and improvements in the quality of life for patients. There is now evidence that newer, highly potent, nitrogen-containing bisphosphonates reduce skeletal complications in patients with bone metastases from other solid tumors (including lung cancer). The early identification of patients at high risk for developing bone metastases may help curtail a complex and costly clinical problem--skeletal-related events. In this article, we review the different mechanisms of bisphosphonates and the potential role of newer-generation bisphosphonates, such as zoledronic acid, in the management of advanced, metastatic bone disease. We include a review of mechanistic studies and preclinical data. Additionally, the utility of evolving concepts such as bone markers and imaging of bone metastases are discussed.
随着癌症治疗的最新进展，转移性骨病患者的临床病程可能会延长，会出现诸如疼痛、高钙血症、病理性骨折、脊髓和神经受压等骨相关事件。双膦酸盐的使用已使包括乳腺癌、前列腺癌和骨髓瘤在内的多种肿瘤的骨相关并发症减少，并改善了患者的生活质量。现在有证据表明，更新的、高效的含氮双膦酸盐可减少其他实体瘤（包括肺癌）骨转移患者的骨并发症。早期识别发生骨转移高危患者可能有助于减少一个复杂且代价高昂的临床问题——骨相关事件。在本文中，我们综述了双膦酸盐的不同作用机制以及新一代双膦酸盐（如唑来膦酸）在晚期转移性骨病治疗中的潜在作用。我们纳入了机制研究和临床前数据的综述。此外，还讨论了诸如骨标志物和骨转移成像等不断发展的概念的实用性。
