Double-Blind Placebo-Controlled Trial of Adjuvant Pamidronate with Palliative Radiotherapy and Intravenous Doxorubicin for Canine Appendicular Osteosarcoma Bone Pain
Autor: | Wanda J. Gordon-Evans, Dominique J. Griffon, Jackie M. Wypij, L. P. De Lorimier, Timothy M. Fan, Laura D. Garrett, S. C. Charney |
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Rok vydání: | 2009 |
Předmět: |
Male
medicine.medical_specialty Bone density medicine.medical_treatment Placebo-controlled study Pamidronate Antineoplastic Agents Placebo Canine Osteosarcoma Dogs Double-Blind Method medicine Animals Pain Management Dog Diseases Bone pain Dual-energy X-ray absorptiometry Bone mineral Analgesics Osteosarcoma Bone Density Conservation Agents Diphosphonates Radiotherapy General Veterinary medicine.diagnostic_test business.industry Extremities Surgery Radiation therapy Doxorubicin Anesthesia Female Analgesia medicine.symptom business |
Zdroj: | Journal of Veterinary Internal Medicine. 23:152-160 |
ISSN: | 1939-1676 0891-6640 |
DOI: | 10.1111/j.1939-1676.2008.0221.x |
Popis: | Background: Canine osteosarcoma (OSA) causes focal malignant osteolysis leading to severe pain. Despite the documented efficacy of radiotherapy or IV aminobisphosphonates for managing cancer bone pain, their potential combined therapeutic value has not been reported in OSA-bearing dogs. Hypothesis: Pamidronate combined with standardized palliative therapy will improve pain control and bone biologic effects in OSA-bearing dogs. Animals: Fifty dogs with appendicular OSA treated with standardized palliative therapy and either pamidronate or sterile saline. Methods: Randomized, prospective, double-blinded, placebo-controlled study. Treatment responses for dogs receiving standardized palliative therapy with (n = 26) or without (n = 24) adjuvant pamidronate were serially evaluated for changes in subjective pain scores, urine N-telopeptide (NTx) excretion, primary tumor relative bone mineral density (rBMD), and computerized pressure platform gait analysis. Results: Median duration of subjective pain relief for dogs treated with adjuvant pamidronate or placebo was 76 and 75 days, respectively (P= .39). Forty percent (20/50; pamidronate [11/26] and placebo [9/24]) of dogs experienced durable analgesia, defined by pain alleviation ≥112 days. For patients achieving durable pain control, dogs treated with pamidronate achieved greater reductions in NTx excretion and larger increases in rBMD compared with placebo controls. Changes in peak vertical force assessed by computerized pressure platform gait analysis correlated with pain alleviation in OSA-bearing dogs. Conclusions and Clinical Importance: Combining pamidronate with standardized palliative therapy is safe, but does not clearly improve pain alleviation. However, in dogs achieving durable pain control, adjuvant pamidronate appears to decrease focal bone resorption in the local tumor microenvironment. |
Databáze: | OpenAIRE |
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