Saad Fred, Higano Celestia S, Sartor Oliver, Colombel Marc, Murray Robin, Mason Malcolm D, Tubaro Andrea, Schulman Claude
Universite de Montreal, Quebec, Canada.
Clin Genitourin Cancer. 2006 Mar;4(4):257-62. doi: 10.3816/CGC.2006.n.004.
In this study, we provide consensus guidelines for the use of bisphosphonates in men with prostate cancer. To this end, an expert panel composed of urologists, medical oncologists, radiation oncologists, and endocrinologists met to review current clinical evidence for the use of bisphosphonates in patients with different stages of prostate cancer to derive consensus recommendations. Physicians should be proactive in monitoring bone loss in patients receiving long-term androgen-deprivation therapy for prostate cancer. Further study is needed before recommending the routine use of bisphosphonates in men with nonmetastatic prostate cancer. However, if a patient has clinically significant bone loss, use of a bisphosphonate to prevent further compromise of bone integrity should be strongly considered, regardless of hormonal and metastatic status. Bone scans are the preferred method for the identification of bone metastases. In patients with hormone-refractory prostate cancer and bone metastases, zoledronic acid is the only bisphosphonate indicated for the prevention of skeletal complications. In conclusion, patients with prostate cancer are at high risk for skeletal morbidity. Bisphosphonates have been shown to prevent cancer treatment-induced bone loss in men receiving androgen-deprivation therapy as well as skeletal complications in men with bone metastases. However, further study of the use of bisphosphonates across the clinical spectrum of prostate cancer is needed.
在本研究中，我们提供了前列腺癌男性患者使用双膦酸盐的共识指南。为此，一个由泌尿科医生、医学肿瘤学家、放射肿瘤学家和内分泌学家组成的专家小组召开会议，审查双膦酸盐在不同阶段前列腺癌患者中使用的当前临床证据，以得出共识性建议。对于接受前列腺癌长期雄激素剥夺治疗的患者，医生应积极监测骨质流失情况。在推荐双膦酸盐在非转移性前列腺癌男性患者中常规使用之前，还需要进一步研究。然而，如果患者存在具有临床意义的骨质流失，无论其激素和转移状态如何，都应强烈考虑使用双膦酸盐来预防骨完整性的进一步损害。骨扫描是识别骨转移的首选方法。在激素难治性前列腺癌和骨转移患者中，唑来膦酸是唯一被指定用于预防骨骼并发症的双膦酸盐。总之，前列腺癌患者发生骨骼疾病的风险很高。双膦酸盐已被证明可预防接受雄激素剥夺治疗男性的癌症治疗引起的骨质流失以及骨转移男性的骨骼并发症。然而，需要对双膦酸盐在前列腺癌临床范围内的使用进行进一步研究。
