High-dose intravenous pamidronate for metastatic bone pain

摘要: The bisphosphonates are able to relieve pain from metastatic bone disease and, when given intravenously, may promote healing of lytic metastases. In this study, the aim was assess acute effects a single 'high-dose' intravenous treatment with pamidronate on pain, mobility, analgesic consumption and quality life (QOL). Thirty-four normocalcaemic patients painful progressing metastases (22 breast, five prostate seven others) received infusion 120 mg as palliative therapy. No other systemic therapy or drugs known influence metabolism were administered during study. Patients' subjective response assessed weekly questionnaire recording composite intensity, performance status consumption. addition, completed Rotterdam Symptom Check List (RSCL) for measurement QOL mobility questionnaire. mean reduction in score (recorded at least two occasions) 25% [standard error (s.e.) 3%, range 0-75%]. Twenty (59%) showed > = 20% improvement classified responders. median duration symptomatic 12 (range 4-24 +) weeks. responding RSCL (improvement QOL) 35% before 27% 6 weeks, but no significant noted non-responders. Twenty-one retreated their symptoms deteriorated again. Eight out 15 responders second 20%, not seen any six Five have remained well additional than repeat infusions every 3-6 months. Treatment tolerated. (24%) experienced fever after first only, four had asymptomatic, biochemical evidence hypocalcaemia. inhibition osteoclastic resorption induced by high-dose can provide useful palliation Responding be dictate good effect. We currently running phase III double-blind trial progressive exclude placebo effect observer bias.