Pain control with zoledronic acid in patients with breast cancer and metastatic bone disease
Tóm tắt
Effective management of pain associated with metastatic bone disease is paramount in the care of cancer patients. Bisphosphonates are recommended in treating skeletal complications and there is evidence that they also control pain. To investigate the effects of zoledronic acid, a potent nitrogen-containing bisphosphonate, in reducing pain in patients with advanced breast cancer and bone metastases. Thirty-two patients (age range 37–79 years, median 56 years) with histologically proven breast cancer and bone metastases received a 15-minute infusion of zoledronic acid 4mg every 4 weeks for a mean of eight cycles (range 1–13) in a phase II pilot study. The primary efficacy endpoint was the control of pain as determined by changes in pain and analgesic scores. Zoledronic acid substantially reduced pain scores compared with baseline, with over 80% of patients reporting mild or no pain at the end of the trial (82% had moderate to very severe pain on entry). The percentage of patients requiring no analgesics increased from 9% to 35% following zoledronic acid treatment. At baseline, 47% of patients required opioids to control pain, whereas 27% required opioids at the end of the trial. Zoledronic acid appeared to be well tolerated, with no patients reporting serious adverse events. These results support previous data indicating that zoledronic acid is effective in patients with breast cancer and painful bone metastases. Follow-up controlled trials are required to further investigate the role of zoledronic acid in the management of cancer patients with metastatic disease.
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