Metastatic bone disease: clinical features, pathophysiology and treatment strategies
Metastatic bone disease: clinical features, pathophysiology and treatment strategies
复制标题
DOI：
10.1053/ctrv.2000.0210
复制
发表时间：
2001-06-01
影响因子：
11.8
通讯作者：
Coleman, RE
中科院分区：
文献类型：
--
作者：
Coleman, RE
转移性骨疾病的发展是肿瘤细胞和骨细胞之间许多相互作用的结果。这导致正常骨代谢的破坏，在大多数情况下，破骨细胞活性增加。如果不是全部的话，肿瘤类型提供了合理的治疗目标。多发性骨髓瘤、乳腺癌和前列腺癌中的转移性骨疾病的临床病程相对较长，患者在数年内经历连续的骨骼并发症。包括骨痛。骨折高钙血症和脊髓压迫，所有这些都可能严重损害患者的生活质量。外部射束放射治疗和全身内分泌和细胞毒性治疗是晚期癌症的主要治疗方法。然而，现在很清楚，双膦酸盐提供了一种额外的治疗策略：减少骨受累的症状和并发症。正在进行的研究旨在试图确定双膦酸盐在转移性骨疾病和预防和治疗癌症患者骨质疏松症中的最佳途径，剂量，时间表和类型。体外直接抗癌活性的建议和早期乳腺癌的一些有希望的临床数据已经引起了对双膦酸盐可能的辅助使用以抑制骨转移发展的相当大的兴趣。(C)2001年哈考特出版社有限公司
Metastatic bone disease develops as a result of the many interactions between tumour cells and bone cells. This leads to disruption of normal bone metabolism, with the increased osteoclast activity seen in most. if not all, tumour types providing a rational target for treatment. The clinical course of metastatic bone disease in multiple myeloma, breast and prostate cancers is relatively long, with patients experiencing sequential skeletal complications over a period of several years. These include bone pain. fractures. hypercalcaemia and spinal cord compression, all of which may profoundly impair a patient's quality of life.External beam radio-therapy and systemic endocrine and cyto-toxic treatments are the mainstay of treatment in advanced cancers. However, it is now clear that the bisphosphonates provide an additional treatment strategy: which reduces both the symptoms and complications of bone involvement. Ongoing research is aimed at trying to define the optimum route, dose, schedule and type of bisphosphonate in metastatic bone disease and in the prevention and treatment of osteoporosis in cancer patients. in vitro suggestions of direct anticancer activity and some promising clinical data in early breast cancer have resulted in considerable interest in the possible adjuvant use of bisphosphonates to inhibit the development of bone metastases. (C) 2001 Harcourt Publishers Ltd.