Gralow Julie, Tripathy Debu
University of Washington School of Medicine, Seattle, Washington 98109, USA.
J Pain Symptom Manage. 2007 Apr;33(4):462-72. doi: 10.1016/j.jpainsymman.2007.01.001.
Approximately two-thirds of patients with bone metastases have severe and debilitating pain. Despite a range of treatments, about 25% of patients with painful bone metastases suffer from uncontrolled pain. Bisphosphonates are the standard care for the reduction of skeletal events associated with bone metastases. We review the efficacy of currently available bisphosphonates in cancer-related bone pain. Oral clodronate, intravenous (i.v.) pamidronate, and i.v. zoledronic acid have shown an analgesic effect in some studies. Both i.v. and oral ibandronate reduced bone pain in breast cancer patients with bone metastases and maintained bone pain scores below baseline levels for up to two years in clinical trials. Pilot studies of intensive i.v. ibandronate dosing show rapid and effective relief from moderate-to-severe bone pain in patients with breast cancer and other tumors. Phase III trials are warranted to compare the efficacy of bisphosphonates in treating bone pain and to confirm the effects of intensive dosing regimens.
约三分之二的骨转移患者患有严重且使人虚弱的疼痛。尽管有一系列治疗方法，但约25%的伴有疼痛的骨转移患者仍遭受疼痛无法控制的困扰。双膦酸盐是减少与骨转移相关的骨事件的标准治疗方法。我们综述了目前可用的双膦酸盐在癌症相关骨痛方面的疗效。在一些研究中，口服氯膦酸盐、静脉注射帕米膦酸盐和静脉注射唑来膦酸已显示出镇痛作用。在临床试验中，静脉注射和口服伊班膦酸盐均能减轻乳腺癌骨转移患者的骨痛，并使骨痛评分在长达两年的时间内维持在基线水平以下。静脉注射高剂量伊班膦酸盐的初步研究表明，乳腺癌和其他肿瘤患者的中重度骨痛能得到快速有效的缓解。有必要进行III期试验以比较双膦酸盐在治疗骨痛方面的疗效，并确认高剂量给药方案的效果。
