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Spinal and femoral bone mineral density in women with breast cancer: Effect of clodronate therapy
63 ORAL CLQDRONATE IMPROVES THE QUALXTY OF LIFE IN LUNG. .CANCER PATXENTS WITH BONE METASTASES. . K. Liiouo. (Intr. by 1. Puolijoolnoki. Km
62 EFFECTIVE TREATMENT i)F MALIGNANT HYPERCALCAEMIA LJSiWG A SlNG,LE INTRtVENOUS INFUSION gFECLODR;;iATE. N&Q&U&&_ I *II. J.Ka& WHO’ vlic Bone &eases, University cf Sheffield Medic01 School, UK. Thirty patients with proven malign?nq and associated hyperculcaemia, which persisted followmg rehydm!iqn, were treated with ;I smgle dose of 1SOOm clodronnte. This W;LS administered intravenously in 500m ‘i normal sali?e 0ver futn rior to hours, Serum an’d urine biochemistry were momtored and following treatment and the results were coqlxe (P*with data from 15patients given the conventional regime of5 K 300m intravenous ciodronate daily. ?a e single infusion induced a rapid and significant full in serum calcium, appxent at d;ly 3 (p
ki). Departmentof Diseases of the Chast, University of Turku, Turku, Finland. Several trials have verified the efficacyof clodronatein the treatnent of bone resorption e.g. in multiple myelom&, breast and prostate cancer.We studied the effQct of oial cludronate (Bonefos'capsules: 2403 mg-1600 mg/day) in 7 male patients (age 64-78 years) having squamous cell lung cancer with painful rib metastasesand hypercalcaemia(s-ca 3.4-3.7mmol/l, mean 3.5). Bone metastaseawere diagnosed 13 months (mean) after the primary treatment (surgery in 5, radiotherapyplus chemotherapyin 1 and symptomatic
in 1 case).
In all patients treatment with clodronate raducd S-C5 into tRf2 normal range (e2.6mmol/l, mean 2.4) in 7 days (lp
in
the
that
hospital COSTS. even though the prognosisof
patients with advanced lung cancer with bone metastasesis poor and probably not affectedby clodronate,the therapywill improvethe quality of life in these patients by lowering serum calcium and relieving bone pain. Hospital. costs of metastatic bone disease will also be reduced when the treatmert at home for at least some weeks is enabled.
65
64 SPINAL AND FEMORAL BONE MlNERAL l3ENSIl-Y IN WOMEN WITH BREAST CANCER: EFFECT QF CLODRONATE
EFFECTS OF CEODRONATE AND CALCJTONIN ON ----._.. __._~ __ BONE RESORPTION IN METASTATIC: BREAST CANCER.
eneva 4, Switrerlon
Bone histomorphometry was studied in 36 normocalcemic women with osteolytic metastases due to breast cancer. Twelve patients on clodronate (CL) (1.6 g daily orally), 82 patients on calcitonin (CT) (salmon calcitonin 100 IU S.C) and 12 patients on placebo Cp1(5 on oral placebo and 7 on placebo injections) underwent a bone biopsy before treatment, and after 6 months treatment with CL or after 6 to 12 months treatment with CT and P. Biopsies from CLtreated patients were tetracycline labeled. Bone resorption, as judged by eroded surface, osteoclast surface and osteoclast density was increased in all treatment groups. CL induced a significant decrease in osteoclast surface (from 1.58+8.3 to 0.11t.0.05, p
scare. Afar stmtificxion for the presence or not of B&t and for the length OF Bhlct evolution, the patients were mndomly alkated to 2 groups with Ckxironate Ire‘rPtmentor not (1600 mg!day onlly). As compared with the untreated controls, fasting urinay calcium was lower in the Clodronnte-treated group after 9.SkO.3 months (O.lfikO.04 vs 0.4MO.04 mmol/mmol creptinine) and serum asttocalein was stabilized (-2X&1.2 vs +5.7&$0 pg./l in controls). in womenwith BMct. LS BMl) increased by 6~5~1.7% in the Ckdrcnnte-treated group after 10.2~k.0~2months, whereas Bhlll of noflp ?ftheskeletsl sites in untrested controls or in the group in r+Ynls%ron did signikmrly ehange.Thcse results indicate thnt women with metast& breast cancer or in remission had LS, FN and FS BhlUIB not different from normal individuals. In these patients, $k-ir0niite treatmentdecxxed bone turn over and led to an incrcsse
tn LS BMD. Thus, ir qgears that C\odronae could bvourably influent@ box mass in pxtienn with breast cmcer.
S28
62 EFFECTIVE TREATMENT i)F MALIGNANT HYPERCALCAEMIA LJSiWG A SlNG,LE INTRtVENOUS INFUSION gFECLODR;;iATE. N&Q&U&&_ I *II. J.Ka& WHO’ vlic Bone &eases, University cf Sheffield Medic01 School, UK. Thirty patients with proven malign?nq and associated hyperculcaemia, which persisted followmg rehydm!iqn, were treated with ;I smgle dose of 1SOOm clodronnte. This W;LS administered intravenously in 500m ‘i normal sali?e 0ver futn rior to hours, Serum an’d urine biochemistry were momtored and following treatment and the results were coqlxe (P*with data from 15patients given the conventional regime of5 K 300m intravenous ciodronate daily. ?a e single infusion induced a rapid and significant full in serum calcium, appxent at d;ly 3 (p
ki). Departmentof Diseases of the Chast, University of Turku, Turku, Finland. Several trials have verified the efficacyof clodronatein the treatnent of bone resorption e.g. in multiple myelom&, breast and prostate cancer.We studied the effQct of oial cludronate (Bonefos'capsules: 2403 mg-1600 mg/day) in 7 male patients (age 64-78 years) having squamous cell lung cancer with painful rib metastasesand hypercalcaemia(s-ca 3.4-3.7mmol/l, mean 3.5). Bone metastaseawere diagnosed 13 months (mean) after the primary treatment (surgery in 5, radiotherapyplus chemotherapyin 1 and symptomatic
in 1 case).
In all patients treatment with clodronate raducd S-C5 into tRf2 normal range (e2.6mmol/l, mean 2.4) in 7 days (lp
in
the
that
hospital COSTS. even though the prognosisof
patients with advanced lung cancer with bone metastasesis poor and probably not affectedby clodronate,the therapywill improvethe quality of life in these patients by lowering serum calcium and relieving bone pain. Hospital. costs of metastatic bone disease will also be reduced when the treatmert at home for at least some weeks is enabled.
65
64 SPINAL AND FEMORAL BONE MlNERAL l3ENSIl-Y IN WOMEN WITH BREAST CANCER: EFFECT QF CLODRONATE
EFFECTS OF CEODRONATE AND CALCJTONIN ON ----._.. __._~ __ BONE RESORPTION IN METASTATIC: BREAST CANCER.
eneva 4, Switrerlon
Bone histomorphometry was studied in 36 normocalcemic women with osteolytic metastases due to breast cancer. Twelve patients on clodronate (CL) (1.6 g daily orally), 82 patients on calcitonin (CT) (salmon calcitonin 100 IU S.C) and 12 patients on placebo Cp1(5 on oral placebo and 7 on placebo injections) underwent a bone biopsy before treatment, and after 6 months treatment with CL or after 6 to 12 months treatment with CT and P. Biopsies from CLtreated patients were tetracycline labeled. Bone resorption, as judged by eroded surface, osteoclast surface and osteoclast density was increased in all treatment groups. CL induced a significant decrease in osteoclast surface (from 1.58+8.3 to 0.11t.0.05, p
scare. Afar stmtificxion for the presence or not of B&t and for the length OF Bhlct evolution, the patients were mndomly alkated to 2 groups with Ckxironate Ire‘rPtmentor not (1600 mg!day onlly). As compared with the untreated controls, fasting urinay calcium was lower in the Clodronnte-treated group after 9.SkO.3 months (O.lfikO.04 vs 0.4MO.04 mmol/mmol creptinine) and serum asttocalein was stabilized (-2X&1.2 vs +5.7&$0 pg./l in controls). in womenwith BMct. LS BMl) increased by 6~5~1.7% in the Ckdrcnnte-treated group after 10.2~k.0~2months, whereas Bhlll of noflp ?ftheskeletsl sites in untrested controls or in the group in r+Ynls%ron did signikmrly ehange.Thcse results indicate thnt women with metast& breast cancer or in remission had LS, FN and FS BhlUIB not different from normal individuals. In these patients, $k-ir0niite treatmentdecxxed bone turn over and led to an incrcsse
tn LS BMD. Thus, ir qgears that C\odronae could bvourably influent@ box mass in pxtienn with breast cmcer.
S28