Abstract
The aim of our study was to assess the clinical efficacy and toxicity of ibandronate in the management of symptomatic skeletal metastases due to prostate cancer (PCA). Twenty-five patients with painful osseous metastases due to hormone refractory PCA (HRPCA) were treated with 6â mg ibandronate every 4 weeks in an open prospective non-randomized clinical study. Primary study endpoint was pain reduction documented by the use of a 10-point visual analog scale. Palliative response with significant reduction in pain score from 6.5 (5â10) to 2.0 [(0â4), P<0.001] was achieved in 23 (92%) patients; nine patients (39%) were completely pain free. Bisphosphonate treatment of painful osseous metastases due to HRPCA resulted in a significant pain reduction and a significant decrease of daily consumption of analgesics in 92% of the patients. Both characteristics are paralleled by an increase in Karnofsky index mainly due to better mobility. Bisphosphonates should have a definite role in the palliative management of symptomatic HRPCA.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 4 print issues and online access
$259.00 per year
only $64.75 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Parker SL et al. Cancer statistics 1997 CA Cancer J Clin 1997 47: 5
Issacs JT . The biology of hormone refractory prostate cancer Urol Clin North Am 1999 26: 263â273
Smith JA, Soloway MS, Young MJ . Complications of advanced prostate cancer Urology 1999 54: 8â14
Clarke NW, McClure J, George NJR . Morphometric evidence for bone resorption and replacement in prostate cancer Br J Urol 1991 68: 74â80
Body JJ et al. Current use of bisphosphonates in oncology J Clin Oncol 1998 16: 3890â3899
Heidenreich A et al. The use of bisphosphonates for the palliative treatment of painful bone metastases due to hormone refractory prostate cancer J Urol 2001 165: 136â140
MÃŒhlbauer RC et al. BM 21.0955, a potent new bisphosphonate to inhibit bone resorption J Bone Mineral Res 1991 6: 1003â1011
Fleisch H . Bisphosphonates in Bone Disease Stampfli, Berne 1993
Lang SH et al. Scatter factor influences the formation of prostate epithelial cell colonies on bone marrow stromain vitro Clin Exp Metas 1999 17: 333â340
Lang SH et al. The interaction of prostatic epithelia with human bone marrow stroma Prostate 1998 34: 203â213
Purohit P et al. High dose intravenous pamidronate for metastastic bone pain Br J Cancer 1994 70: 554â558
Ernst DS et al. A randomized controlled trial of intravenous clodronate in patients with metastatic bone disease and pain J Pain Symptom Manage 1997 13: 319â326
Adami S et al. Dichloromethylene diphosphonate in patients with carcinoma of the prostate metastatic to the skeleton J Urol 1985 134: 1152â1154
Smith JA . Palliation of painful bone metastases from prostate cancer using sodium etidornate: results of randomised, prospective placebo controlled study J Urol 1989 141: 85â87
Clarke NW, McClure J, George NJR . Disodium pamidronate identifies differential osteoclastic bone resorption in metastatic prostate cancer Br J Urol 1992 69: 64â68
Cresswell S et al. Pain relief and quality of life assessment following intravenous and oral clodronate in hormone escaped prostate cancer Br J Urol 1995 76: 360â365
Harvey A et al. The role of bisphosphonates in the treatment of bone metastasesâthe US experience Support Care Cancer 1996 4: 213â217
Kylmala T et al. The effect of combined and oral clodronate on bone pain in patients with metastastatic prostate cancer Ann Chir Gynaecol 1994 83: 316â319
Vorreuther R . Bisphosphonates as an adjunct to palliative therapy in patients with metastases from prostate carcinoma. A pilot study on clodronate Br J Urol 1993 72: 792â795
Ralston SH . Pathogenesis and management of hypercalcaemia In: Rubens RD, Fogelman I (eds) Bone Metastases: Diagnosis and Treatment Springer Verlag, London 1991 pp 99â117
Ralston SH et al. Dose-response study of ibandronate in the treatment of cancer-associated hypercalcaemia Br J Cancer 1997 75: 295â300
Gallacher SJ et al. Breast cancer associated hypercalcaemia: a reassessment of renal calcium and phosphate handling Ann Clin Biochem 1990 27: 551â556
Grill V et al. Parathyroid hormone related protein: elevated levels in both humoral hypercalcaemia of malignancy and hypercalcaemia complicating breast cancer J Clin Endocrinol Metab 1991 73: 1309â1315
Urwin GH et al. Generalised increase in bone resorption in carcinoma of the prostate Br J Urol 1985 57: 721
Clarke NW, McClure J, George NJR . Osteoblastic function and osteomalacia in metastatic prostate cancer Eur Urol 1993 24: 286
Taube T et al. Distinction between focally accelerated bone formation and osteomalacia in carcinoma of prostate metastasised to bone Br J Urol 1993 72: 98
Bichler K-H et al. Investigations on bone metabolism of urological tumors forming metastases Urol Int 1996 56: 61â68
Tannock IF et al. Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone resistant prostate cancer: a Canadian randomized trial with palliative endpoints J Clin Oncol 1996 14: 1756
Kanthoff PW et al. Hydrocortisone with or without mitoxantrone in men with hormone refractory prostate cancer: results of the cancer and leukemia group B 9182 study J Clin Oncol 1999 17: 2506
Biossier S et al. Bisphosphonates inhibit breast and prostate carcinoma cell invasion, an early event in the formation of bone metastases Cancer Res 2000 60: 2949â2954
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Heidenreich, A., Elert, A. & Hofmann, R. Ibandronate in the treatment of prostate cancer associated painful osseous metastases. Prostate Cancer Prostatic Dis 5, 231â235 (2002). https://doi.org/10.1038/sj.pcan.4500574
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.pcan.4500574
Keywords
This article is cited by
-
Patient-reported outcome instruments used to assess pain and functioning in studies of bisphosphonate treatment for bone metastases
Supportive Care in Cancer (2012)
-
SekundÀr- und TertiÀrprÀvention urologischer Tumore
Der Urologe (2011)
-
Effects of intravenous zoledronic acid and oral ibandronate on early changes in markers of bone turnover in patients with bone metastases from non-small cell lung cancer
International Journal of Clinical Oncology (2011)
-
Bisphosphonates as adjuvant therapy in multimodal pain management
memo - Magazine of European Medical Oncology (2009)
-
Médicaments de lâostéolyse tumorale
Oncologie (2009)