Masuda N, Yayoi E, Furukawa J, Maruhashi S, Tokunaga M, Takiguchi S, Matsui S, Yano H, Tateishi H, Kinuta M, Maruyama H, Okamura J
Dept. of Surgery, Osaka Teishin Hospital.
Gan To Kagaku Ryoho. 1998 May;25(6):845-51.
A total of 91 breast cancer patients died of advanced and recurrent breast cancer at the Osaka Teishin Hospital from 1986 to 1996. There were 18 cases (19.8%) among them showing hypercalcemia (serum corrected Ca > or = 11.0 mg/dl). These 18 cases were analyzed to determine the incidence of hypercalcemia and to find a more effective treatment. All these patients had multiple bone metastases during their clinical course, and six patients (33.3%) had pathologic bone fracture just before the occurrence of hypercalcemia. Their common symptoms were general fatigue, gastrointestinal symptoms, renal dysfunction or neurological symptoms. There was no definitive correlation between clinical signs and serum calcium values. Among various therapies, the use of pamidronate disodium (Aredia) in combination with hydration, steroid and calcitonin was found to be the most effective treatment for hypercalcemia. The survival time from the diagnosis of hypercalcemia in the patients undergoing treatment with Aredia was significantly better than without it (p < 0.01). This suggests that Aredia should be effective and useful for advanced breast cancer patients with hypercalcemia.
1986年至1996年期间，大阪帝心医院共有91例乳腺癌患者死于晚期和复发性乳腺癌。其中18例（19.8%）出现高钙血症（血清校正钙≥11.0mg/dl）。对这18例患者进行分析，以确定高钙血症的发生率并寻找更有效的治疗方法。所有这些患者在临床过程中均有多处骨转移，6例患者（33.3%）在高钙血症发生前出现病理性骨折。他们的常见症状为全身乏力、胃肠道症状、肾功能不全或神经症状。临床体征与血清钙值之间无明确相关性。在各种治疗方法中，发现使用帕米膦酸二钠（阿可达）联合补液、类固醇和降钙素是治疗高钙血症最有效的方法。接受阿可达治疗的患者从高钙血症诊断后的生存时间明显长于未接受该治疗的患者（p<0.01）。这表明阿可达对晚期乳腺癌伴高钙血症患者应是有效且有用的。
