Palliative pamidronate treatment in patients with bone metastases from breast cancer
| Autor: | Socrates E. Papapoulos, Harm Sleeboom, H.M. Kroon, L.V.A.M. Beex, J.P. Neijt, G. Blijham, Olav L. M. Bijvoet, Jo Hermans, F.J. Cleton, A.T.M. van Holten-Verzantvoort |
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| Rok vydání: | 1993 |
| Předmět: |
Cancer Research
medicine.medical_specialty Palliative care Bone disease medicine.medical_treatment Mammary gland Pamidronate Bone Neoplasms Breast Neoplasms Gastroenterology Metastasis Breast cancer Oral administration Internal medicine Surveys and Questionnaires medicine Humans Chemotherapy Diphosphonates Dose-Response Relationship Drug business.industry Palliative Care Bisphosphonate Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Oncology Multivariate Analysis Quality of Life Regression Analysis Female business |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 11(3) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE An open, randomized study was performed to assess the effects of supportive pamidronate treatment on morbidity from bone metastases in breast cancer patients. PATIENTS AND METHODS Eighty-one pamidronate patients and 80 control patients were monitored for a median of 18 and 21 months, respectively, for events of skeletal morbidity and the radiologic course of metastatic bone disease. The oral pamidronate dose was 600 mg/d (high dose [HD]) during the earliest study years, then changed to 300 mg/d (low dose [LD]) because of gastrointestinal toxicity. Twenty-nine of 81 pamidronate (HD/LD) patients first received 600 mg/d and were then changed to 300 mg/d; 52 of 81 pamidronate LD patients received 300 mg/d throughout the study. Tumor treatment was unrestricted. RESULTS An overall intent-to-treat analysis was performed. In the pamidronate group, the occurrence of hypercalcemia, severe bone pain, and symptomatic impending fractures decreased by 65%, 30%, and 50%, respectively; event-rates of systemic treatment and radiotherapy decreased by 35% (P < or = .02). The event-free period (EFP), radiologic course of disease, and survival did not improve. Subgroup analyses suggested a dose-dependent treatment effect. Compared with their controls, in pamidronate HD/LD patients, events occurred 60% to 90% less frequently (P < or = .03) and the EFP was prolonged (P = .002). In pamidronate LD patients, event-rates decreased by 15% to 45% (P < or = .04). Gastrointestinal toxicity of pamidronate caused a 23% drop-out rate, but other cancer-associated factors seemed to contribute to this toxicity. CONCLUSION Pamidronate treatment of breast cancer patients efficaciously reduced skeletal morbidity. The effect appeared to be dose-dependent. Further research on dose and mode of treatment is mandatory. |
| Databáze: | OpenAIRE |
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