Incidence and consequences of bone metastases in lung cancer patients.
Incidence and consequences of bone metastases in lung cancer patients.
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DOI：
10.1016/j.jbo.2012.12.004
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发表时间：
2013-02
影响因子：
3.4
通讯作者：
Wheatley-Price P
中科院分区：
文献类型：
--
作者：
Kuchuk M;Addison CL;Clemons M;Kuchuk I;Wheatley-Price P
骨转移瘤(BM)在非小细胞肺癌患者中很常见。尽管骨靶向治疗有一些潜在的积极作用，但它们在非小细胞肺癌中的应用很少，这可能与晚期肺癌的整体预后不良有关。我们回顾了在试验和非试验临床环境中评价骨靶向药物在患有骨髓的肺癌患者中的发生率、后果和使用情况的文献。已发表的前瞻性和回顾性研究肺癌和骨髓的论文，在试验和非试验环境下，被确定并在这篇综述中讨论。BM在晚期肺癌患者中很常见，通常以疼痛和骨骼相关事件(SRE)为症状。骨转换标记物水平高、多发性骨髓和病理性骨折病史的患者总体生存时间较短。在随机研究中，骨靶向疗法降低了SRE的风险，延长了首次SRE的时间。骨靶向制剂的使用也可能与生存益处有关。骨髓瘤是晚期肺癌的常见问题。虽然骨靶向疗法的好处已经得到证明，但它们在非试验人群中的使用有限。如果有更好的个体风险预测标记物，这可能会增加骨靶向药物的适当使用。
Bone metastases (BM) are common in NSCLC patients. Despite some potential positive effects of bone-targeted therapies, their use in NSCLC is infrequent, which may relate to the overall poor prognosis of advanced lung cancer. We reviewed the literature to evaluate the incidence, consequences and use of bone-targeting agents in lung cancer patients with BM in both the trial and non-trial clinical setting. Published prospective and retrospective papers investigating lung cancer and BM, in trial and non-trial settings, were identified and are discussed in this review. BM are common in patients with advanced lung cancer and often present symptomatically with pain and skeletal related events (SREs). Patients with high bone turnover marker levels, multiple BM, and history of pathological fractures have shorter overall survival. In randomized studies bone-targeted therapies reduced the risk of SREs and prolonged the time to first SRE. The use of bone-targeted agents may also be associated with a survival benefit. BM are a common problem in advanced lung cancer. While the benefits of bone-targeted therapies have been demonstrated, their use is limited in non-trial populations. If better predictive markers of individual risk were available this might increase the appropriate use of bone-targeted agents.