Fernández-Conde M, Alcover J, Aaron J E, Ordi J, Carretero P
Department of Urology, Hospital Clinic, Barcelona, Spain.
Am J Clin Oncol. 1997 Oct;20(5):471-6. doi: 10.1097/00000421-199710000-00007.
Bone metastases, together with generalized bone resorption, represent the main complication in patients with advanced prostate cancer, and palliative treatments are required to delay the progression of the metastases and improve the quality of life of these patients. For this reason, the bisphosphonate clodronate was administered to 18 patients (clodronate group) from a total of 30, all of whom were receiving complete androgenic blockade; the remaining 12 formed the control group. Transiliac bone biopsies were taken at the beginning of the study and 6 months later to determine the effect of the bisphosphonate on the skeleton. The results were assessed by bone histomorphometry and showed, although without statistical significance between the groups, an antiresorptive effect of the clodronate expressed as the eroded surface/bone surface and as the osteoclast number/bone surface. However, the bone volume also decreased after 6 months of treatment. Similarly, osteoid formation decreased as indicated by the osteoid surface and by the osteoid volume, probably due to the effect of the drug on the osteoblasts. The mineralization rate was apparently slightly retarded in the clodronate group, although to a lesser degree than in the control group. The results confirm the antiresorptive effect of clodronate and its detrimental effect on osteoblast activity.
骨转移以及全身性骨吸收是晚期前列腺癌患者的主要并发症，需要进行姑息治疗以延缓转移进程并改善这些患者的生活质量。因此，在总共30例均接受完全雄激素阻断治疗的患者中，18例患者接受了双膦酸盐氯膦酸盐治疗（氯膦酸盐组）；其余12例组成对照组。在研究开始时及6个月后进行髂骨活检，以确定双膦酸盐对骨骼的影响。通过骨组织形态计量学评估结果，结果显示，尽管两组之间无统计学意义，但氯膦酸盐的抗吸收作用表现为侵蚀表面/骨表面以及破骨细胞数量/骨表面。然而，治疗6个月后骨体积也有所下降。同样，类骨质形成减少，表现为类骨质表面和类骨质体积减少，这可能是由于药物对成骨细胞的作用。氯膦酸盐组的矿化速率明显略有延迟，尽管程度低于对照组。结果证实了氯膦酸盐的抗吸收作用及其对成骨细胞活性的有害作用。
