Mehrotra Bhoomi
Clinical Medicine, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11040, USA.
Semin Oncol. 2007 Dec;34(6 Suppl 4):S24-7. doi: 10.1053/j.seminoncol.2007.10.007.
Because of their proven efficacy, intravenous bisphosphonates play an important role in reducing the risk of skeletal-related events including pathologic fractures, spinal cord compression, and palliative radiotherapy to bone in patients with malignant bone lesions. Overall, intravenous bisphosphonates have an acceptable safety profile and are commonly associated with transient and manageable flu-like symptoms after initial infusions. In addition, bisphosphonates have dose- and infusion rate-dependent effects on renal function that can be proactively managed in patients with reduced creatinine clearance rates by following recommended dosing guidelines. Recently, there have been reports of osteonecrosis of the jaw (ONJ) in patients with advanced cancer receiving complex chemotherapeutic treatment regimens and supportive care with bisphosphonates. ONJ prevention and management recommendations have been developed that may reduce the risk of ONJ and the impact of ONJ on quality of life. Moreover, bisphosphonate therapy has resulted in considerable clinical benefits in patients with malignant bone disease; therefore, the potential for adverse events such as ONJ must be placed into context with these meaningful benefits.
由于已证实的疗效，静脉注射双膦酸盐在降低骨相关事件风险方面发挥着重要作用，这些事件包括病理性骨折、脊髓压迫以及恶性骨病变患者的骨姑息性放疗。总体而言，静脉注射双膦酸盐具有可接受的安全性，并且在初次输注后通常会出现短暂且可控的流感样症状。此外，双膦酸盐对肾功能有剂量和输注速率依赖性影响，对于肌酐清除率降低的患者，可通过遵循推荐的给药指南来积极管理。最近，有报道称接受复杂化疗方案和双膦酸盐支持治疗的晚期癌症患者出现了颌骨坏死（ONJ）。已制定了ONJ预防和管理建议，这可能会降低ONJ的风险以及ONJ对生活质量的影响。此外，双膦酸盐治疗已在恶性骨病患者中产生了显著的临床益处；因此，必须将诸如ONJ等不良事件的可能性与这些有意义的益处联系起来考虑。
