A novel study investigating the therapeutic outcome of patients with lytic, mixed and sclerotic bone metastases treated with combined radiotherapy and ibandronate

Abstract

Even though the therapeutic outcome for the three groups was similar, the degree of clinical response and reossification differed.

Pathogenesis and Bisphosphonate Treatment of Skeletal Events and Bone Pain in Metastatic Cancer: Focus on Ibandronate

“…Mean bone density increasedby73%at10months.Similarresultswereobtained inasecondseriesof52patients [66],completepainresponse rates were > 76.4% at all assessments, opioid consumption wasmarkedlyreduced,andsignificantimprovementsinpain scores, QoL (QLQ-C30) and Karnofsky performance status (KPS)werereported.…”

Pain outcomes in patients with bone metastases from advanced cancer: assessment and management with bone-targeting agents

“…A phase 3 study in 470 patients with metastatic prostate cancer indicated that a single dose of local radiotherapy provided pain relief (combination of WHO pain ladder score and analgesic use) similar to a single dose of intravenous ibandronate [59]. In two small observational studies (N=70 and N=45), ibandronate combined with externalbeam radiotherapy in patients with bone metastases from solid tumors significantly decreased opioid use (P<0.001 in both studies) and improved pain scores relative to baseline [60,61]. However, despite these preliminary results, prospective randomized studies are needed to determine whether the combination of a bone-targeting agent with radiotherapy is more effective for pain relief than radiotherapy alone.…”

Anatomic and functional imaging in the diagnosis of spine metastases and response assessment after spine radiosurgery

“…It is best at evaluating bony structures with accuracy and can readily reveal reossification after successful treatment. 53,54 Reossification has been shown to occur in response to effective RT in several studies 8,21,[53][54][55] and to correlate with improvements in symptomatic pain scores. Peri-lesional fibrosis, such as lung fibrosis after thoracic SSRS, can also be easily identified on CT.…”