Risks and benefits of bisphosphonates.
Risks and benefits of bisphosphonates.
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双膦酸盐的风险和益处。
DOI：
10.1038/sj.bjc.6604382
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发表时间：
2008-06-03
影响因子：
8.8
通讯作者：
Coleman, R. E.
中科院分区：
文献类型：
--
作者：
Coleman, R. E.
骨是癌症中最常见的转移部位，由于这些疾病的流行，在乳腺癌和前列腺癌中具有特别重要的临床意义。骨转移导致相当高的发病率和对医疗资源的复杂需求，影响生活质量和独立性的时间是几年而不是几个月。双膦酸盐已被证明可以将多发性骨髓瘤和影响骨骼的各种实体肿瘤的骨骼发病率降低30%-50%。非常恰当的是，这些药物越来越多地与抗癌治疗一起使用，以防止骨骼并发症和缓解骨骼疼痛。在早期癌症中使用双膦酸盐也越来越重要，以防止癌症治疗对骨骼健康的不利影响。这些措施包括乳腺癌患者的卵巢抑制和芳香酶抑制剂的使用，以及前列腺癌患者的雄激素剥夺治疗。类似于用于治疗绝经后骨质疏松症的双膦酸盐治疗策略表明，双膦酸盐是预防治疗引起的骨丢失的一种安全有效的治疗方法。与其他癌症疗法相比，与双膦酸盐治疗相关的不良事件的频率和严重程度通常较轻且不常见；因此，任何双膦酸盐治疗的好处几乎总是大于风险。然而，肾功能障碍可能偶尔会发生，近年来，一种新的实体，双膦酸盐相关性颌骨坏死(ONJ)已被描述。讨论了发病率、临床重要性和预防策略，以最大限度地减少这一问题对需要双磷酸盐的患者的影响。
Bone is the most common site for metastasis in cancer and is of particular clinical importance in breast and prostate cancers due to the prevalence of these diseases. Bone metastases result in considerable morbidity and complex demands on health care resources, affecting quality of life and independence over years rather than months. The bisphosphonates have been shown to reduce skeletal morbidity in multiple myeloma as well as a wide range of solid tumours affecting bone by 30–50%. Quite appropriately, these agents are increasingly used alongside anticancer treatments to prevent skeletal complications and relieve bone pain. The use of bisphosphonates in early cancer is also increasingly important to prevent the adverse effects of cancer treatments on bone health. These include ovarian suppression and the use of aromatase inhibitors in breast cancer patients and androgen deprivation therapy in those with prostate cancer. Bisphosphonate strategies, similar to those used to treat postmenopausal osteoporosis, have suggested that bisphosphonates are a safe and effective treatment for the prevention of treatment-induced bone loss. When compared to other cancer therapies, the frequency and severity of adverse events related to bisphosphonate therapy are generally mild and infrequent; thus, the benefits of treatment with any bisphosphonate almost always outweigh the risks. However, renal dysfunction may occasionally occur and over recent years, a new entity, bisphosphonate-associated osteonecrosis of the jaw (ONJ), has been described. The incidence, clinical importance and prevention strategies to minimise the impact of this problem on patients requiring bisphosphonates is discussed.
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影响因子：
45.3
作者：
Coleman, RE;Major, P;Cook, R
通讯作者：
Cook, R
影响因子：
45.3
作者：
Gnant, Michael F. X.;Mlineritsch, Brigitte;Jakesz, Raimund
通讯作者：
Jakesz, Raimund
影响因子：
4.4
作者：
McKeage, Kate;Plosker, Greg L.
通讯作者：
Plosker, Greg L.
影响因子：
6.6
作者：
Reed, SD;Radeva, JI;Schulman, KA
通讯作者：
Schulman, KA
影响因子：
45.3
作者：
Kyle, Robert A.;Yee, Gary C.;Anderson, Kenneth
通讯作者：
Anderson, Kenneth