Kamoto Toshiyuki
Department of Urology, Faculty of Medicine, University of Miyazaki.
Clin Calcium. 2011 Mar;21(3):465-71.
Bone metastases and skeletal complications are major causes of morbidity in prostate cancer patients. Despite an osteoblastic appearance of bone metastases on imaging studies, patients have high osteoclast activity. Current evidence indicates that newer-generation nitrogen-containing bisphosphonates, particularly zoledronic acid, are potent inhibitors of bone resorption via suppression of osteoclast activity. Indeed, zoledronic acid has been reported to significantly decrease the risk of skeletal complications in men with castration-resistant prostate cancer and bone metastases. Additionally, an increased understanding of the pathogenesis of bone metastasis has resulted in the development of several bone-targeted therapies, including a monoclonal antibody targeting the receptor activator of nuclear factor-κB ligand. In this paper, the current state and the future of bone metastases management from prostate cancer are outlined.
骨转移和骨骼并发症是前列腺癌患者发病的主要原因。尽管在影像学研究中骨转移表现为成骨样,但患者的破骨细胞活性很高。目前的证据表明,新一代含氮双膦酸盐,特别是唑来膦酸,通过抑制破骨细胞活性是骨吸收的有效抑制剂。事实上,据报道唑来膦酸可显著降低去势抵抗性前列腺癌和骨转移男性患者发生骨骼并发症的风险。此外,对骨转移发病机制的深入了解促成了几种骨靶向治疗方法的发展,包括一种靶向核因子-κB受体活化因子配体的单克隆抗体。本文概述了前列腺癌骨转移治疗的现状和未来。