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靶向癌症引起的骨骼损伤:一种全面理解病理生理学、机制及管理解决方案的方法。

Targeting cancer-induced skeletal damage: a holistic approach to understanding pathophysiology, mechanisms, and management solutions.

作者信息

Gu Xinyi, Xiang Dejian, Zhu Haozhong, He Xiaoqian, Yang Chenhui, Chen Rongjin

机构信息

Department of Oncology, Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine) Chengdu 611130, Sichuan, The People's Republic of China.

The First People's Hospital of Guangyuan Guangyuan 628000, Sichuan, The People's Republic of China.

出版信息

Am J Cancer Res. 2025 Apr 15;15(4):1494-1516. doi: 10.62347/QFHJ2430. eCollection 2025.

Abstract

Cancer's insidious reach extends far beyond its initial site, particularly manifesting in the skeleton, where it precipitates a spectrum of pathological conditions ranging from bone metastases and cachexia to primary bone cancers. This review highlights the critical impact of cancer on skeletal health, including the development of bone metastases, cachexia, and primary bone cancers, underscoring the importance of understanding the complex interaction between cancer and the bones. It emphasizes the global burden of cancer and its skeletal complications, which severely affect quality of life. The article reviews the prevalence of bone metastases in various cancers, such as breast, prostate, lung, renal cancers, and multiple myeloma, and stresses the need for targeted treatments. It also discusses the mechanisms behind tumor spread to bones and the systemic effects of cancer, including reduced bone mineral density and increased fracture risk, even without direct bone invasion. The challenges posed by primary bone cancers, which are rarer but highly aggressive, are also examined, highlighting the role of genetics and molecular research in treatment development. The review calls for a multidisciplinary approach to manage the severe symptoms of cancer-induced bone damage and explores the potential of personalized medicine to improve treatment outcomes. It concludes by advocating for continued research and collaboration to develop more precise and personalized therapies for cancer-related bone issues, aiming to improve the lives of those affected.

摘要

癌症的隐匿影响远远超出其原发部位,尤其在骨骼中表现明显,它会引发一系列病理状况,从骨转移和恶病质到原发性骨癌。本综述强调了癌症对骨骼健康的关键影响,包括骨转移、恶病质和原发性骨癌的发展,突显了理解癌症与骨骼之间复杂相互作用的重要性。它强调了癌症及其骨骼并发症的全球负担,这些严重影响生活质量。文章回顾了各种癌症(如乳腺癌、前列腺癌、肺癌、肾癌和多发性骨髓瘤)中骨转移的患病率,并强调了靶向治疗的必要性。它还讨论了肿瘤扩散至骨骼的机制以及癌症的全身影响,包括即使没有直接骨侵袭时骨矿物质密度降低和骨折风险增加。原发性骨癌虽较为罕见但具有高度侵袭性,其所带来的挑战也得到了审视,突显了遗传学和分子研究在治疗开发中的作用。该综述呼吁采用多学科方法来管理癌症引起的骨损伤的严重症状,并探索个性化医疗改善治疗效果的潜力。它最后倡导持续开展研究与合作,以开发针对癌症相关骨问题更精确、个性化的疗法,旨在改善患者生活。

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