Gerson R, Serrano OA, Villalobos PA

Language: Spanish
References: 15
Page: 7-11
PDF size: 115.69 Kb.

ABSTRACT

Background: Humoral and non-humoral mechanisms are involved in osseous metastasis. The most common manifestation is pain. Objective: To evaluate therapeutic and side effects related to the administration of pamidronate in cancer patients with bone metastases. Patients and methods: Patients with malignancy, metastatic to bone that received at least one pamidronate application were included. Patients simultaneously using other calcium bounds were excluded. Pamidronate was applied at doses of 90 mg IV during 120 minutes, every 30 days. We analyzed age, gender, type of tumor, metastatic sites, indication for pamidronate therapy, number of applications, associated symptoms. Serum calcium and alkaline phosphatase were determined. Pain intensity score 0 to 10. Results: 10 male, 24 female, 58.38 ± 15.84 years, 16 to 84. Breast cancer in 20 patients, 58.8%, multiple myeloma, 5, 14.7%; prostate 4, 11.7%; lung 3, 8.8%; paraganglioma and Paget disease 1, 2.9%. Two or more metastatic sites 27.8%. Indications for pamidronate therapy: severe pain 27 patients, 79.4%; fracture risk 7, 20.6%. Twelve patients received radiation therapy because of severe pain. Mean pamidronate application 3.24 ± 1.6. Moderate or severe osseous pain in 5, 14.7%; muscle weakness 2, 5.88% and flu-like, nausea and vomiting in one patient, 2.94%. Pain intensity before treatment 8.71 ± 1.57, 4 to 10; after first cycle 3.77 ± 2.58, 0 to 10; p ‹ 0.0001. Initial serum calcium 8.96 ± 0.60, 7 to 10 mg/dL; alkaline phosphatase 121 mg/dL, 36 to 903. After second application of pamidronate serum calcium 8.93 ± 0.6 mg/dL, 8.94 to 9.6; alkaline phosphatase 121.5 mg/dL, 50 to 920, p › 0.05. Transtrochanteric fracture before treatment with pamidronate was observed in 3 patients. Conclusion: Pamidronate is associated to low grade and infrequent side effects. It did not alter significatively serum calcium nor alkaline phosphatase levels. Pamidronate reduced bone pain intensity. Pamidronate can be simultaneously administrated with radiotherapy.

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