Bone metastasis is a common feature of certain primary tumors and it can lead to a series of complication, e.g. pain, fractures or nervous dysfunction, which severely impair the quality of life. Hypercalcemia, the main metabolic complication of
tumor-associated osteolysis, presents often an cute, life threatening situation.
Clodronate(Ostac(r)), a substance of the bisphosphonate class, is the first preparation capable of specific inhibition of tumor-related bone destruction, and favorable effects on bone pain.
To evaluate the efficacy of clodronate on osteolysis by bone metastasis, twelve patients with hypercalcemia and/or bone pain by bone metastasis were treated with clodronate. Clodronate was administered intrabvenously at a dose of 300 mg per day
for
first 5 consecutive days, followed by daily oral administration at a dose of 1600 mg per day orally over a period of 3 months. The blood chemistry analysis such as calcium, alkaline phosphatase and phosphorus was measured sequentially before and
after
clodronate therapy in all patients.
The age of patients ranged from 36 to 71 years with a median of 54, and the male to female ratio was 7 : 5 Five patients had the lung primaries and four had breast cancer, and the other primaries included kidney, pyriform sinus and skin. Seven
patients
had hypercalcemia, and 6 patients had marked bone pain. All patients showed an objective responses. In 7 hypercalcemic patients, raised serum calcium levels were reduced within 7 adys by administration of clodronate significantly in all(13.2±0.4
mg/dl
on day O vs. 8.7±0.7 mg/dl on day 7, p<0.01). There were no change in their serum alkaline phosphatase or phosphorus levels. In 5 normocalcemic patients with bone pain, their serum calcium, alkaline phosphatase and phosphorus levels had no
change
to
clodronate therapy. Bone pain in 6 patients decreased markedly and the use of analgesics was also reduced in all patients. There was no side effects associated with clodronate therapy,
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