1633 - Bisphosphonates in bone metastatic patients: experience of medical oncology, university of l'aquila over 17 years

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Presenter Enrico Ricevuto
Authors E. Ricevuto1, A. Irelli2, K. Cannita3, G. Bruera4, P. Lanfiuti Baldi5, V. Cocciolone4, E. Palluzzi1, L. Rinaldi5, A. Teti6, C. Ficorella3
  • 1Oncologia Medica, University of L'Aquila, 67100 - L'Aquila/IT
  • 2U.o.c. Oncologia Medica, University of L'Aquila, 67100 - L'Aquila/IT
  • 3Medical Oncology Division, S. Salvatore Hospital, University of L'Aquila, 67100 - L'Aquila/IT
  • 4University of L'Aquila, 67100 - L'Aquila/IT
  • 5Medical Oncology Division, S. Salvatore Hospital, University of L'Aquila, L'Aquila/IT
  • 6Department Of Experimental Medicine, University of L'Aquila, L'Aquila/IT

Abstract

Three hundred and twenty-nine bone metastatic patients (BMP) followed at Medical Oncology Division, San Salvatore Hospital L'Aquila from 1995 were evaluated. Primary tumors were: breast 113, 55%; prostate 29, 14%; lung 26, 13%. Treatment with bisphosphonates was administered in 204 patients, 62% (male/female, 80/124): zoledronic acid and/or intravenous pamidronate 178, 87%; ibandronate 16, 8%; and ibandronate followed by intravenous bisphosphonate 10, 5%. Median duration of treatment was 7 months (range 1-47months), 19,5 months (range 1-57months) and 27 months (range 9-44months), respectively. Features of bone metastases: multiple bone sites 193 (95%), one bone site 11 (5%); osteolytic 124 (61%), osteosclerotic lesions 35 (17%), mixed 28 (14%), undetermined 17 (8%). Involved sites: spinal column, 172 (84%); pelvis/hip, 146 (72%); long bones, 102 (50%); other skeletal sites, 156 (76%). Overall skeletal–related events (SREs) during follow up were 140 (69%): pathologic fracture, 45 (22%); spinal cord compression, 6 (3%); bone RT, 120 (59%); bone surgery, 14 (7%). The first occurring SRE was: pathologic fracture in 28 patients (20%); spinal cord compression, 3 (2%); bone RT, 108 (77%); bone surgery, 1 (1%). Number of SREs in individual patient was: 1 in 54%; 2 in 25%; 3 in 17%; 4 in 7%; 6 in 1%. SREs before onset of treatment with bisphosphonate were 99 (71%), after treatment were 41 (29%). A baseline mouth assessment with dental visit and/or orthopantomography of the jaws was performed in 58% of patients, 2% also with TAC or RMN. Median survival after diagnosis of bone metastases was 32 months. Median time to first SRE after diagnosis of bone metastases was 15 days. Median survival after first SRE was 29 months. Events related to bisphosphonate were: acute phase reactions (first 3 days), 6 (2,5%); pyrexia, 5 (2%); bone pain, 2 (0,8%); arthralgia, 1 (0,4%); hypercalcemia, 4 (1,7%); hypocalcemia, 7 (2,9%); toothache, 3 (1,25%); osteonecrosis of the jaw (ONJ), 6 (2,5%); uveitis, 1 (0,4%). ONJ before and after introduction of baseline mouth assessment, 4/65 patients (6.1%) and 2/139 patients (1,4%), respectively. Our experience confirms the relevance of SREs and efficacy of bisphosphonate treatment in BMP.

Disclosure

All authors have declared no conflicts of interest.