Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna General Hospital, Vienna, Austria.
HOPE Department, St James's Hospital, Dublin, Ireland.
Ann Oncol. 2012 Sep;23(9):2215-2222. doi: 10.1093/annonc/mds009. Epub 2012 Feb 22.
Bone metastases are a significant and undertreated clinical problem in patients with advanced lung cancer.
We reviewed the incidence of bone metastases and skeletal-related events (SREs) in patients with lung cancer and examined the burden on patients' lives and on health care systems. Available therapies to improve survival and lessen the impact of SREs on quality of life (QoL) were also investigated.
Bone metastases are common in lung cancer; however, owing to short survival times, data on the incidences of SREs are limited. As with other cancers, the costs associated with treating SREs in lung cancer are substantial. Bisphosphonates reduce the frequency of SREs and improve measures of pain and QoL in patients with lung cancer; however, nephrotoxicity is a common complication of therapy. Denosumab, a recently approved bone-targeted therapy, is superior to zoledronic acid in increasing the time to first on-study SRE in patients with solid tumours, including lung cancer. Additional roles of bone-targeted therapies beyond the prevention of SREs are under investigation.
With increasing awareness of the consequences of SREs, bone-targeted therapies may play a greater role in the management of patients with lung cancer, with the aim of delaying disease progression and preserving QoL.
骨转移是晚期肺癌患者存在的重大且治疗不足的临床问题。
我们回顾了肺癌患者骨转移和骨骼相关事件（SREs）的发生率，并研究了这些事件对患者生活和医疗保健系统造成的负担。同时，还研究了改善生存和减轻 SREs 对生活质量（QoL）影响的可用疗法。
骨转移在肺癌中很常见；然而，由于生存时间较短，SRE 发生率的数据有限。与其他癌症一样，治疗肺癌 SRE 的相关成本也很高。双膦酸盐可降低 SRE 的频率，并改善肺癌患者的疼痛和 QoL 指标；然而，治疗相关的肾毒性是常见的并发症。地舒单抗，一种最近批准的骨靶向治疗药物，在增加包括肺癌在内的实体瘤患者首次研究 SRE 的时间方面优于唑来膦酸。目前正在研究骨靶向治疗在预防 SRE 之外的其他作用。
随着对 SRE 后果认识的提高，骨靶向治疗可能在肺癌患者的管理中发挥更大的作用，目的是延缓疾病进展并保持 QoL。
