Major Pierre
McMaster University, Juravinski Cancer Centre, 699 Concession Street, Hamilton, Ontario, Canada L8V 5C2.
Eur J Oncol Nurs. 2007;11 Suppl 2:S32-7. doi: 10.1016/j.ejon.2007.07.003. Epub 2007 Sep 4.
Skeletal-related events (SREs) from bone metastases are a major cause of morbidity and significantly decrease patients' quality of life. Strategies for the optimal management of SREs with bisphosphonates are explored.
Existing and novel therapies were identified and published guidelines were reviewed through PubMed key word searches.
Nitrogen-containing bisphosphonates effectively reduce the risk of SREs in patients with bone metastases from a variety of solid tumors and bone lesions from multiple myeloma. Review of placebo-controlled trials in breast cancer patients with bone metastases indicated that zoledronic acid produced the greatest SRE risk reduction of all bisphosphonates evaluated. Zoledronic acid has demonstrated significant long-term benefits for prevention of SREs and palliative effects for bone pain. Zoledronic acid also improves quality of life. Analysis of recent trials indicates that early zoledronic acid intervention provides greater benefit in asymptomatic patients.
Patients with malignant bone disease are at a continuous risk for SREs, and bisphosphonates reduce the incidence and delay the onset of SREs. Zoledronic acid has demonstrated the greatest SRE risk reduction of all bisphosphonates and significantly improves pain scores in patients with breast cancer. Zoledronic acid is the only bisphosphonate to show efficacy in prostate cancer, lung cancer, and other solid tumors.
骨转移引起的骨相关事件（SREs）是发病的主要原因，显著降低患者的生活质量。探讨了用双膦酸盐类药物优化管理SREs的策略。
通过PubMed关键词搜索确定现有和新型疗法，并查阅已发表的指南。
含氮双膦酸盐可有效降低多种实体瘤骨转移患者以及多发性骨髓瘤骨病变患者发生SREs的风险。对骨转移乳腺癌患者的安慰剂对照试验进行回顾发现，唑来膦酸在所有评估的双膦酸盐类药物中降低SREs风险的效果最为显著。唑来膦酸已证明对预防SREs具有显著的长期益处，对骨痛具有姑息作用。唑来膦酸还可改善生活质量。近期试验分析表明，早期使用唑来膦酸进行干预对无症状患者更有益处。
恶性骨病患者持续面临发生SREs的风险，双膦酸盐类药物可降低SREs的发生率并延缓其发生。唑来膦酸在所有双膦酸盐类药物中降低SREs风险的效果最为显著，并可显著改善乳腺癌患者的疼痛评分。唑来膦酸是唯一在前列腺癌、肺癌和其他实体瘤中显示出疗效的双膦酸盐类药物。
