Aapro Matti S
Institut Multidisciplinaire d'Oncologie Clinique de Genolier, Genolier, Switzerland.
Semin Oncol. 2007 Dec;34(6 Suppl 4):S28-32. doi: 10.1053/j.seminoncol.2007.10.002.
Bisphosphonates have become important tools for the treatment of bone lesions from various solid tumors or from multiple myeloma. Management of bone health in patients with malignant bone disease from breast cancer, prostate cancer, lung cancer, and multiple myeloma was discussed in clinical case workshops held during the ZENITH meeting (April 2007, Prague, Czech Republic). Physicians in attendance were generally in agreement that bisphosphonate therapy is recommended for treatment of bone metastases and that treatment should be sustained over the duration of disease progression. Consensus is still evolving regarding the optimal duration of therapy and the emerging role of bisphosphonates in the management of bone loss in the adjuvant setting. Bisphosphonates have proven efficacy in reducing and delaying skeletal-related events in patients with bone metastases, and play a key role in preserving patient functional independence and quality of life. Furthermore, bisphosphonate therapy is a cost-effective strategy in the care of patients with bone metastases compared with the cost of treatment for fractures and other skeletal complications. Finally, communication with patients is critical to increase awareness of the benefits of bisphosphonate therapy. Increased patient involvement with treatment decisions will likely encourage patient compliance and thereby maximize clinical benefit from bisphosphonate therapy.
双膦酸盐已成为治疗各种实体瘤或多发性骨髓瘤所致骨病变的重要工具。在ZENITH会议（2007年4月，捷克共和国布拉格）期间举办的临床病例研讨会上，讨论了乳腺癌、前列腺癌、肺癌和多发性骨髓瘤所致恶性骨病患者的骨骼健康管理。与会医生普遍一致认为，推荐双膦酸盐疗法用于治疗骨转移，且治疗应在疾病进展期间持续进行。关于最佳治疗持续时间以及双膦酸盐在辅助治疗中防治骨质流失方面的新作用，目前仍在形成共识。双膦酸盐已被证明在减少和延缓骨转移患者的骨相关事件方面有效，并且在维持患者功能独立性和生活质量方面发挥关键作用。此外，与治疗骨折和其他骨骼并发症的费用相比，双膦酸盐疗法在骨转移患者护理中是一种具有成本效益的策略。最后，与患者沟通对于提高患者对双膦酸盐疗法益处的认识至关重要。患者更多地参与治疗决策可能会鼓励患者依从性，从而使双膦酸盐疗法的临床益处最大化。
