Saad Fred, Lipton Allan
Department of Surgical Oncology, Centre Hospitalier de l'Université de Montréal/Hôpital Notre-Dame, Montréal, Quebec, Canada.
Semin Oncol. 2007 Dec;34(6 Suppl 4):S17-23. doi: 10.1053/j.seminoncol.2007.10.006.
Patients with metastatic bone disease are at risk for developing skeletal-related events that can negatively influence quality of life, contributing to loss of autonomy and functional capabilities. Bisphosphonates have become an important component in the treatment of patients with bone metastases as they delay the onset and reduce the risk of skeletal-related events and also palliate or control bone pain in multiple cancer types, thus preserving quality of life. Zoledronic acid has proven efficacy and safety in patients with bone lesions from breast cancer, prostate cancer, lung cancer, and other solid tumors, as well as in patients with multiple myeloma. Current data suggest that early treatment with zoledronic acid (before the onset of bone pain) may provide additional clinical benefits and also positive effects on survival in subsets of patients who have elevated levels of N-telopeptide of type I collagen (NTX), a biochemical marker of bone resorption. Studies have shown that in patients with breast cancer, prostate cancer, lung cancer, or other solid tumors, normalization of elevated levels of NTX was observed in the majority of patients who received zoledronic acid. Furthermore, normalization of NTX values correlated with extended survival.
转移性骨病患者有发生骨相关事件的风险，这些事件会对生活质量产生负面影响，导致自主性和功能能力丧失。双膦酸盐已成为治疗骨转移患者的重要组成部分，因为它们可延迟骨相关事件的发生并降低其风险，还能缓解或控制多种癌症类型的骨痛，从而维持生活质量。唑来膦酸已在患有乳腺癌、前列腺癌、肺癌和其他实体瘤骨病变的患者以及多发性骨髓瘤患者中证明了其疗效和安全性。目前的数据表明，早期使用唑来膦酸治疗（在骨痛发作之前）可能会带来额外的临床益处，并且对I型胶原N-端肽（NTX）水平升高的部分患者的生存也有积极影响，NTX是骨吸收的生化标志物。研究表明，在患有乳腺癌、前列腺癌、肺癌或其他实体瘤的患者中，大多数接受唑来膦酸治疗的患者NTX升高水平恢复正常。此外，NTX值的正常化与生存期延长相关。
