McGill University Health Centre, Montreal, Quebec, Canada.
Clin Lung Cancer. 2009 Jul;10(4):223-9. doi: 10.3816/CLC.2009.n.030.
Lung cancer is one of the most common cancers diagnosed worldwide. As the disease progresses, patients with lung cancer can develop metastasis to the bone. However, because early-stage bone disease may be asymptomatic, bone metastases often go undiagnosed, resulting in delayed initiation of treatment to prevent skeletal complications. In the absence of bone-targeted therapies, patients with metastatic bone disease are at increased risk for potentially debilitating skeletal-related events (SREs) including pathologic fracture, spinal cord compression, hypercalcemia of malignancy, and the requirement for surgery or radiation therapy to bone. The majority of patients with bone metastases from lung cancer will develop SREs, and this number is expected to increase with the improvement of primary therapies that are prolonging the lives of patients. Zoledronic acid is the only bisphosphonate that has been extensively studied in patients with bone metastases from lung cancer, and it has demonstrated efficacy in delaying the onset and reducing the risk of SREs in this setting. Preventing SREs with zoledronic acid may preserve the quality of life and functional independence of these patients. Recent exploratory analyses of a phase III study in patients with bone metastases from lung cancer or other solid tumors revealed that zoledronic acid also normalizes biochemical markers of bone metabolism and may also improve survival in specific patient subsets. Additional ongoing clinical trials are assessing further benefits and antitumor activity of zoledronic acid in the adjuvant setting in the prevention of bone metastases in patients with lung cancer.
肺癌是全球最常见的癌症之一。随着疾病的进展，肺癌患者可能会发生骨转移。然而，由于早期骨病可能无症状，骨转移常常得不到诊断，导致治疗开始延迟，无法预防骨骼并发症。在没有骨靶向治疗的情况下，转移性骨病患者发生骨骼相关事件（SREs）的风险增加，包括病理性骨折、脊髓压迫、恶性高钙血症以及需要手术或放射治疗骨骼。大多数肺癌骨转移患者会发生 SREs，并且随着延长患者生命的主要治疗方法的改进，这一数字预计会增加。唑来膦酸是唯一一种在肺癌骨转移患者中进行了广泛研究的双膦酸盐，它在该治疗环境中已被证明能延迟 SREs 的发生并降低其风险。用唑来膦酸预防 SREs 可能有助于保持这些患者的生活质量和功能独立性。最近对一项针对肺癌或其他实体瘤骨转移患者的 III 期研究的探索性分析显示，唑来膦酸还可使骨骼代谢的生化标志物正常化，并可能改善特定患者亚群的生存率。正在进行的其他临床试验正在评估唑来膦酸在辅助治疗环境中预防肺癌患者骨转移的进一步获益和抗肿瘤活性。
