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Dichloromethylene-diphosphonate in patients with prostatic carcinoma metastatic to the skeleton
Abstract:
A total of 17 patients with multiple osteoblastic bone metastases owing to prostatic carcinoma was treated with 2-dichloromethylene-diphosphonate, a powerful inhibitor of bone resorption. The drug was given intravenously (300 mg.) for 2 weeks and then orally (3,200 mg.) or intramuscularly (100 mg.) for 4 to 11 weeks. A definite improvement in pain, assessed by daily consumption of analgesic drugs and by an analogic scale, was observed within 10 days in 16 of the 17 patients. Four patients confined to bed rest for pain were able to walk after 2 weeks and reversal of paralysis also was noted in 1 patient. Transient changes in serum calcium (decreasing) and alkaline phosphatase (increasing) were observed in most patients. In the 3 patients in whom it was performed, repeated bone scanning showed a partial regression of pathological areas in 2 and the complete disappearance of most pathological areas in 1. Our results suggest that 2-dichloromethylene-diphosphonate may represent an important supportive treatment in patients with bone metastases owing to prostatic carcinoma, providing sustained relief of pain and regression of bone destruction without undesirable side effects.
Insights
This study shows that 2-dichloromethylene-diphosphonate effectively treats bone metastases in prostate cancer patients. The drug significantly reduced pain and bone destruction with minimal side effects.
Area of Science:
- Oncology
- Pharmacology
- Bone Metastasis Research
Background:
- Prostate carcinoma frequently metastasizes to bone, causing osteoblastic lesions.
- Bone metastases lead to significant pain and morbidity, impacting patient quality of life.
- Inhibitors of bone resorption are crucial for managing skeletal-related events.
Purpose of the Study:
- To evaluate the efficacy and safety of 2-dichloromethylene-diphosphonate in patients with prostate cancer bone metastases.
- To assess the drug's impact on pain, functional status, and bone lesion progression.
- To determine the potential of this agent as supportive care in advanced prostate cancer.
Main Methods:
- Seventeen patients with multiple osteoblastic bone metastases received 2-dichloromethylene-diphosphonate intravenously followed by oral or intramuscular administration.
- Pain was assessed using daily analgesic consumption and an analogic scale.
- Bone scans were performed to evaluate pathological bone areas.
Main Results:
- Sixteen of 17 patients experienced significant pain improvement within 10 days.
- Four bedridden patients regained mobility; one patient showed reversal of paralysis.
- Bone scans indicated partial or complete regression of metastatic bone lesions in all evaluated patients.
- Transient decreases in serum calcium and increases in alkaline phosphatase were observed.
Conclusions:
- 2-dichloromethylene-diphosphonate demonstrates significant efficacy in alleviating pain and reducing bone destruction in prostate cancer bone metastases.
- The drug offers a favorable safety profile, suggesting its utility as supportive therapy.
- This bisphosphonate represents a promising option for improving outcomes in patients with skeletal complications of prostate cancer.