Effects of Pamidronate Use on the Palliative Radiotherapy of Bone Metastases
William Levin, MD
OncoLink Assistant Editor
Last Modified: October 24, 2000
Presenter: M.N. Yavux Affiliation: Karadeniz University, Trabzone, Turkey
Between 15-70% of all cancer patients are found to have bone metastases over the course of their lifetime.
These lesions are frequently painful, cause a decrease in mobility, and negatively impact on the quality of life.
While radiation therapy can provide symptomatic relief for the majority of patients, more efficacious treatments are still needed.
Pamidronate is a osteoclast inhibitor used for the treatment of bone metastases.
Materials and Methods:
50 patients with bone metastases were randomized to receive either PRT alone or PRT + pamidronate.
The most common primary cancer sites included: breast, lung, multiple myeloma, and prostate.
PRT consisted of 3Gy/day to a total dose of 30Gy
Planned PAM therapy was a 90mg infusion every 3 weeks for a total of 9 months.
Primary endpoints were pain and analgesia assessment, performance status, and quality of life score.
Endpoints were evaluated right before and just after PRT, and on follow-up exam, thereafter.
No significant differences were detected in the changes of pain and analgesia, performance status, quality of life, serum calcium, alkaline phosphatases, and mineral bone density between the two groups.
In PRT and PRT-PAM arms, median time to progression in the PRT field was 26 weeks and 68 weeks, respectively (log rank p = 0.05).
Median time to new bone metastases was 23 and 59 weeks, respectively (log rank p = 0.05).
The addition of PAM to PRT was of no significant advantage, in terms of quality of life, symptomatic palliation, and bone mineralization in the early post-RT period (first 5 months).
The addition of PAM may, however, be of benefit, regarding time to progression in the irradiated field and the occurrence of new bone metastases.
The effective treatment of painful bone metastases remains a significant challenge for the clinician.
New drug therapies should continue to be investigated in an attempt to maximize the efficacy of bone metastasis palliation.
Oct 9, 2013 - Although single-fraction radiotherapy has been shown to be effective for pain relief of bone metastases in patients with prostate cancer, only about 3 percent of elderly patients receive single-fraction compared with multiple-fraction radiotherapy, according to a research letter published in the Oct. 9 issue of the Journal of the American Medical Association.