Facchini G, Caraglia M, Santini D, Nasti G, Ottaiano A, Striano S, Maiolino P, Ruberto M, Fiore F, Tonini G, Budillon A, Iaffaioli R V, Zeppetella G L
Medical Oncology Division B, National Cancer Institute, Naples, Italy.
J Exp Clin Cancer Res. 2007 Sep;26(3):307-12.
Current management of bone metastases involves a multimodal approach. Aminobisphosphonates (BPs) are a valid weapon in the treatment of skeletal localization of tumour disease. Patients with bone metastases from breast and lung cancer were enrolled in order to evaluate the impact of the addition of bisphosphonates therapy to standard treatments in terms of (i) pain control, (ii) quality of life (QoL) and (iii) toxicity and to evaluate (iv) any relations between clinical activity and the occurrence of SREs. A total of 60 patients were included in the study. Median age was 76 years (range 40-83). The majority of patients were treated with chemotherapy or hormonal therapy. All patients received zoledronic acid (ZOL) (4 mg) every 3-4 weeks for at least 3 cycles. No significant improvement in Performance Status of patients after 12 cycles of ZOL (p = 0.1672) was recorded. A statistically significant early and long-lasting amelioration of both pain, narcotic scores and QoL was found. Twenty-one patients (48%) experienced at least one SRE during the study. The most common SRE was radiation to bone (30% of patients). An inverse correlation between bone tumour response and SREs was also found (p = 0.019). ZOL addition induces a clinical benefit and improves QoL of patients with bone metastases. Moreover, the occurrence of bone clinical response is related to a reduced risk of SREs.
目前骨转移瘤的治疗采用多模式方法。氨基双膦酸盐(BPs)是治疗肿瘤疾病骨骼定位的有效手段。纳入了来自乳腺癌和肺癌的骨转移患者,以评估在以下方面将双膦酸盐治疗添加到标准治疗中的影响:(i)疼痛控制,(ii)生活质量(QoL)和(iii)毒性,并评估(iv)临床活动与骨相关事件(SREs)发生之间的任何关系。该研究共纳入60例患者。中位年龄为76岁(范围40 - 83岁)。大多数患者接受了化疗或激素治疗。所有患者每3 - 4周接受唑来膦酸(ZOL)(4mg)治疗,至少3个周期。在12个周期的ZOL治疗后,患者的体能状态无显著改善(p = 0.1672)。发现疼痛、麻醉评分和QoL在早期和长期均有统计学意义的改善。21例患者(48%)在研究期间经历了至少一次骨相关事件。最常见的骨相关事件是骨放疗(30%的患者)。还发现骨肿瘤反应与骨相关事件之间存在负相关(p = 0.019)。添加ZOL可带来临床益处并改善骨转移患者的生活质量。此外,骨临床反应的发生与骨相关事件风险降低有关。