Department of Urology, Hospital 9 de Julho of São Paulo, São Paulo, Brazil.
Cancer Res Treat. 2011 Dec;43(4):231-5. doi: 10.4143/crt.2011.43.4.231. Epub 2011 Dec 27.
High-risk prostate cancer patients undergoing treatment often experience biochemical recurrence. The use of bisphosphonates as an adjuvant treatment delays skeletal events, yet whether or not bisphosphonates also delay metastastic development remains to be determined.
A total of 140 high-risk prostate cancer patients who were undergoing definitive treatment and who had clinically organ-confined disease and who suffered from biochemical recurrence were administered intravenous (IV) clodronate. The patients were treated with a radical retropubic prostatectomy (RP) or curative radiotherapy (RTx). Upon androgen deprivation therapy initiation, tri-monthly IV clodronate was added to the treatment to prevent bone demineralization. Twenty-six out of 60 operated cases and 45 out of 80 irradiated cases received bisphosphonate. The length of time until the first bone metastasis was recorded and analyzed.
No statistical difference was found for the type of primary treatment (RP or RTx) on the time to the first bone metastasis (95% confidence interval [CI], 0.40 to 2.43; p=0.98). However, there was a clear advantage favoring the group that received bisphosphonate (p<0.001). The addition of bisphosphonate delayed the appearance of the first bone metastasis by seven-fold (95% CI, 3.1 to 15.4; p<0.001).
Treatment with tri-monthly IV clodronate delayed the time to the first bone metastasis in high-risk prostate cancer patients who were experiencing an increase in the prostate specific antigen level after definitive treatment.
接受治疗的高危前列腺癌患者常经历生化复发。使用双膦酸盐作为辅助治疗可延迟骨骼事件，但双膦酸盐是否也延迟转移发展仍有待确定。
共有 140 名接受确定性治疗且具有临床器官局限性疾病和生化复发的高危前列腺癌患者接受静脉（IV）氯膦酸盐治疗。患者接受根治性耻骨后前列腺切除术（RP）或根治性放疗（RTx）。在开始雄激素剥夺治疗时，每三个月静脉注射氯膦酸盐以预防骨质脱矿。60 例手术中有 26 例，80 例放疗中有 45 例接受了双膦酸盐治疗。记录并分析首次发生骨转移的时间。
首次骨转移的时间在原发性治疗（RP 或 RTx）类型上无统计学差异（95%置信区间[CI]，0.40 至 2.43；p=0.98）。然而，接受双膦酸盐治疗的组有明显优势（p<0.001）。添加双膦酸盐将首次骨转移的出现时间延迟了七倍（95%CI，3.1 至 15.4；p<0.001）。
在接受确定性治疗后前列腺特异性抗原水平升高的高危前列腺癌患者中，每三个月静脉注射氯膦酸盐可延迟首次骨转移的时间。
