Clinical features of metastatic bone disease and risk of skeletal morbidity
Clinical features of metastatic bone disease and risk of skeletal morbidity
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DOI：
10.1158/1078-0432.ccr-06-0931
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发表时间：
2006-10-15
影响因子：
11.5
通讯作者：
Coleman, Robert E.
中科院分区：
文献类型：
--
作者：
Coleman, Robert E.
骨骼是受转移性癌症影响的最常见器官，也是产生最大发病率的疾病部位。骨骼疾病包括需要放疗的疼痛、高钙血症、病理性骨折和脊髓或神经根压迫。从晚期癌症的随机试验中可以看出，平均每3至6个月发生一次这些主要骨骼事件。此外，转移性疾病可能仍然局限于骨骼，生活质量下降，最终死亡几乎完全是由于骨骼并发症及其治疗。转移性骨疾病的预后取决于原发部位，与肺癌相比，乳腺癌和前列腺癌的生存期以年为单位，而肺癌的平均生存期仅为几个月。此外，骨外疾病的存在以及骨病的范围和克里思是预后的有力预测因素。后者最好通过测量骨特异性标志物来估计，最近的研究表明，骨吸收率与临床结局（骨骼发病率和基础疾病进展或死亡）之间存在很强的相关性。我们对预后和预测因素的更好理解可以为个体患者提供更个性化的治疗，并更经济有效地利用医疗资源。
The skeleton is the most common organ to be affected by metastatic cancer and the site of disease that produces the greatest morbidity. Skeletal morbidity includes pain that requires radiotherapy, hypercalcemia, pathologic fracture, and spinal cord or nerve root compression. From randomized trials in advanced cancer, it can be seen that one of these major skeletal events occurs on average every 3 to 6 months. Additionally, metastatic disease may remain confined to the skeleton with the decline in quality of life and eventual death almost entirely due to skeletal complications and their treatment. The prognosis of metastatic bone disease is dependent on the primary site, with breast and prostate cancers associated with a survival measured in years compared with lung cancer, where the average survival is only a matter of months. Additionally the presence of extraosseous disease and the extent and tempo of the bone disease are powerful predictors of outcome. The latter is best estimated by measurement of bone-specific markers, and recent studies have shown a strong correlation between the rate of bone resorption and clinical outcome, both in terms of skeletal morbidity and progression of the underlying disease or death. Our improved understanding of prognostic and predictive factors may enable delivery of a more personalized treatment for the individual patient and a more cost-effective use of healthcare resources.