Centre de recherche du Centre hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada.
Curr Opin Support Palliat Care. 2012 Sep;6(3):299-303. doi: 10.1097/SPC.0b013e328356da87.
Bone metastases alone or in combination with androgen deprivation therapy-related bone loss places prostate cancer patients at greater risk for skeletal morbidities, including pain, pathologic fracture and spinal cord compression. These events significantly impair the patient's quality of life and place a significant burden on health-care resources.
This review focuses on the management options for reducing skeletal morbidity in patients with prostate cancer, including life-style modifications, food supplementation, osteoclast-targeted therapy and selective estrogen-receptor modulators.
The use of osteoclast-targeted therapy (denosumab and zoledronic acid) is supported by the strongest evidence and has been US Food and Drug Administration-approved for the treatment of patients with PCa at high risk of osteoporotic fractures and for the reduction of the risk of skeletal-related events in patients with castration-resistant prostate cancer. Ongoing trials are studying the potential role of osteoclast-targeted therapy in other settings throughout the course of the disease.
单纯骨转移或与雄激素剥夺治疗相关的骨丢失会使前列腺癌患者面临更大的骨骼并发症风险，包括疼痛、病理性骨折和脊髓压迫。这些事件严重影响患者的生活质量，并给医疗资源带来巨大负担。
本综述重点关注降低前列腺癌患者骨骼并发症风险的管理选择，包括生活方式改变、饮食补充、破骨细胞靶向治疗和选择性雌激素受体调节剂。
破骨细胞靶向治疗（地舒单抗和唑来膦酸）的应用得到了最强有力的证据支持，并已获得美国食品和药物管理局批准，用于治疗有发生骨质疏松性骨折高风险的前列腺癌患者，以及降低去势抵抗性前列腺癌患者发生骨骼相关事件的风险。正在进行的试验正在研究破骨细胞靶向治疗在疾病过程中的其他情况下的潜在作用。
