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Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis: a single-institution report

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Abstract

Goals of work

Bone metastases are a common cause of morbidity in elderly patients with solid tumors and myeloma. We studied the safety and the effect of a new bisphosphonate, zoledronic acid (ZA), on pain and on quality of life (QoL) in elderly patients with bone metastases.

Materials and methods

From January 2004 to December 2005, we have enrolled elderly patients with bone metastasis for receiving ZA administration. Visual analog scale (VAS) and Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire were used to assess potential benefits of ZA therapy.

Results

Eighty-six patients were included; the median age was 75.5 years. Before starting treatment, the mean VAS was 6.8 (±0.24), after three infusions 5.4 (±0.3), and after six courses 4.5 (±0.3) with a significant improvement of bone pain. Moreover, we found a statistically significant improvement of QoL measured by FACT-G questionnaire after six courses (p = 0.010). Median baseline and final value of serum creatinine were 0.73 and 0.72 mg/dl, respectively (p = 0.11); creatinine clearance was also normal for most patients. Osteonecrosis of the jaw was diagnosed in one patient who received a prolonged ZA treatment.

Conclusions

These data confirm the benefits of ZA on pain and QoL also in elderly patients with bone metastasis from solid tumors.

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References

  1. Carteni G, Bordonaro R, Giotta F et al (2006) Efficacy and safety of zoledronic acid in patients with breast cancer metastatic to bone: a multicenter clinical trial. Oncologist 11(7):841–848

    Article  PubMed  CAS  Google Scholar 

  2. Cella DF, Tulsky DS, Gray G et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    PubMed  CAS  Google Scholar 

  3. Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27:165–176

    Article  PubMed  CAS  Google Scholar 

  4. Conte P, Guarnieri V (2004) Safety of intravenous and oral biphosphonates and compliance with dosing regimens. Oncologist 9(Suppl.4):28–37

    Article  PubMed  CAS  Google Scholar 

  5. Gridelli C (2007) The use of bisphosphonates in elderly cancer patients. Oncologist 12(1):62–71

    Article  PubMed  CAS  Google Scholar 

  6. Hortobagyi GN, Theriault RL, Porter L et al (1996) Efficacy of pamidronate in reducing skeletal complications in patients with breast cancer and lytic bone metastases. Protocol 19 Aredia Breast Cancer Study Group. N Engl J Med 335:1785–1791

    Article  PubMed  CAS  Google Scholar 

  7. Hortobagyi GN, Theriault RL, Lipton A et al (1998) Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. Protocol 19 Aredia Breast Cancer Study Group. J Clin Oncol 16:2038–2044

    PubMed  CAS  Google Scholar 

  8. Marco RA, Sheth DS, Boland PJ, Wunder JS, Siegel JA, Healey JH (2000) Functional and oncological outcome of acetabular reconstruction for the treatment of metastatic disease. J Bone Joint Surg Am 82(5):642–651

    PubMed  CAS  Google Scholar 

  9. Rosen LS, Gordon D, Kaminski M et al (2001) Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial. Cancer J 7:377–387

    PubMed  CAS  Google Scholar 

  10. Rosen LS, Gordon D, Tchekmedyian S et al (2003) Zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer and other solid tumors: a phase III, double blind, randomized trial. The Zoledronic Acid Lung Cancer and Other Solid Tumors Study Group. J Clin Oncol 21:3150–3157

    Article  PubMed  CAS  Google Scholar 

  11. Rubens RD (1998) Bone metastases–the clinical problem. Eur J Cancer 34:210–213

    Article  PubMed  CAS  Google Scholar 

  12. Saad F, Gleason DM, Murray R et al (2002) A randomized, placebo controlled trial of zoledronic acid in patients with hormonerefractory metastatic prostate carcinoma. J Natl Cancer Inst 94:1458–1468

    PubMed  CAS  Google Scholar 

  13. Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS (1995) When is cancer pain mild moderate or severe? Grading pain severity by its interference with function. Pain 61:277–284

    Article  PubMed  CAS  Google Scholar 

  14. Tanvetyanon T, Stiff PJ (2006) Management of the adverse effects associated with intravenous biphosphonates. Ann Oncol 17:897–907

    Article  PubMed  CAS  Google Scholar 

  15. Theriault RL (2003) Zoledronic Acid use in bone disease. Expert Rev Anticancer Ther 3(2):156–166

    Article  Google Scholar 

  16. Yancik RM, Ries L (1998) Cancer and age: magnitude of the problem. In: Balducci L, Lyman GH (eds) Comprehensive geriatric oncology. Harwood Academic, London, pp 95–104

    Google Scholar 

  17. Weinfurt KP, Anstrom KJ, Castel LD, Schulman KA, Saad F (2006) Effect of zoledronic acid on pain associated with bone metastasis in patients with prostate cancer. Ann Oncol 17:986–989

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. U.O.C. Oncologia, “S. Giovanni di Dio” Hospital, ASL Napoli3 Via Giovanni XXIII 80020 Frattaminore, Naples, Italy

    Raffaele Addeo, Vincenzo Faiola, Liliana Montella, Rosario Guarrasi, Gregorio Cennamo & Salvatore Del Prete

  2. U.O.C. Radiologia, “S. Giovanni di Dio” Hospital, ASL Napoli3 Frattaminore, Naples, Italy

    Vincenzo Nocera & Eugenio Rossi

  3. Section of Oncology, Campus Biomedico University, Rome, Italy

    Bruno Vincenzi, Giuseppe Tonini & Daniele Santini

  4. Distretto Sanitario 65, ASL Napoli3 Arzano, Naples, Italy

    Gabriella Ferraro & Elena Capasso

  5. Experimental Pharmacology Unit, Experimental Oncology Department, INT Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Michele Caraglia

Authors
  1. Raffaele Addeo
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  2. Vincenzo Nocera
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  3. Vincenzo Faiola
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  4. Bruno Vincenzi
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  5. Gabriella Ferraro
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  6. Liliana Montella
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  7. Rosario Guarrasi
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  8. Eugenio Rossi
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  9. Gregorio Cennamo
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  10. Giuseppe Tonini
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  11. Elena Capasso
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  12. Daniele Santini
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  13. Michele Caraglia
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  14. Salvatore Del Prete
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Corresponding author

Correspondence to Raffaele Addeo.

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Addeo, R., Nocera, V., Faiola, V. et al. Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis: a single-institution report. Support Care Cancer 16, 209–214 (2008). https://doi.org/10.1007/s00520-007-0315-y

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  • DOI: https://doi.org/10.1007/s00520-007-0315-y

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