Harvey H A, Lipton A
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Support Care Cancer. 1996 May;4(3):213-7. doi: 10.1007/BF01682343.
Frequent complications of bone metastases include pain, pathologic fracture, hypercalcemia and spinal cord compression. Lytic bone metastases result from excessive activation of osteoclasts by tumor-produced cytokines. Aredia (pamidronate) is a potent bisphosphonate that inhibits osteoclast activation. In two dose-seeking phase I trials in patients with breast cancer and prostate cancer, repeated intravenous infusion of Aredia was shown to be safe and effective in reducing bone resorption and pain. In a randomized phase III trial of 377 patients with multiple myeloma, Aredia was administered in a dosage of 90 mg i.v. every 4 weeks. Compared with placebo, treatment with Aredia was associated with a significant decrease in bone pain and in the incidence and time to development of all skeleton-related events. Data from two phase III breast cancer trials each involving 300 patients are now being analyzed. The newer bisphosphonates can safely be used together with standard anticancer therapy to provide effective palliation of symptoms caused by lytic bone metastases.
骨转移的常见并发症包括疼痛、病理性骨折、高钙血症和脊髓压迫。溶骨性骨转移是由肿瘤产生的细胞因子过度激活破骨细胞所致。阿可达（帕米膦酸）是一种有效的双膦酸盐，可抑制破骨细胞的激活。在两项针对乳腺癌和前列腺癌患者的剂量探索性I期试验中，反复静脉输注阿可达被证明在减少骨吸收和疼痛方面是安全有效的。在一项针对377例多发性骨髓瘤患者的随机III期试验中，阿可达以每4周静脉注射90毫克的剂量给药。与安慰剂相比，使用阿可达治疗可使骨痛以及所有骨相关事件的发生率和发生时间显著降低。目前正在分析两项分别涉及300例患者的III期乳腺癌试验的数据。新型双膦酸盐可安全地与标准抗癌疗法联合使用，以有效缓解溶骨性骨转移引起的症状。
