Efficacy of pamidronate in pediatric osteosarcoma patients with low bone mineral density
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Purpose: Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients. Methods: Nine osteosarcoma patients (12.8±1.6 years of age; 5 boys and 4 girls) who had a history of nontraumatic fracture or severe pain after completing chemotherapy were included. Intravenous pamidronate (1.5 mg/kg) was given every 6 weeks for 4 to 6 cycles. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy x-ray absorptiometry. Clinical outcomes including acute side effects were also evaluated. Results: After pamidronate treatments, all patients experienced decreased pain. Seven of 9 patients could walk without a crutch. The BMD of lumbar spine was increased by 0.108±0.062 mg/cm2 after 8.4±1.0 months (n=8, P=0.017) and the mean z-score improved from –2.14±0.94 to –1.76±0.95 (P=0.161). Six patients (67%) had an acute-phase reaction, and 2 patients had symptomatic hypocalcemia. Conclusion: Pamidronate appears to be safe and effective for the treatment of osteosarcoma in children with low BMD and bone pain.
Abstract
Purpose: Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients. Methods: Nine osteosarcoma patients (12.8±1.6 years of age; 5 boys and 4 girls) who had a history of nontraumatic fracture or severe pain after completing chemotherapy were included. Intravenous pamidronate (1.5 mg/kg) was given every 6 weeks for 4 to 6 cycles. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy x-ray absorptiometry. Clinical outcomes including acute side effects were also evaluated. Results: After pamidronate treatments, all patients experienced decreased pain. Seven of 9 patients could walk without a crutch. The BMD of lumbar spine was increased by 0.108±0.062 mg/cm2 after 8.4±1.0 months (n=8, P=0.017) and the mean z-score improved from –2.14±0.94 to –1.76±0.95 (P=0.161). Six patients (67%) had an acute-phase reaction, and 2 patients had symptomatic hypocalcemia. Conclusion: Pamidronate appears to be safe and effective for the treatment of osteosarcoma in children with low BMD and bone pain.
참고문헌 (30)
- Ottaviani G, "The epidemiology of osteosarcoma", Cancer Treat Res, 152, pp.3~13 (2009)
- Holzer G, "Bone mineral density in long-term survivors of highly malignant osteosarcoma", J Bone Joint Surg Br, 85, pp.231~237 (2003)
- Lim JS, "Young age at diagnosis, male sex, and decreased lean mass are risk factors of osteoporosis in long-term survivors of osteosarcoma", J Pediatr Hematol Oncol, 35, pp.54~60 (2013)
- Ju Hyun Ahn, "Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma", Annals of Pediatirc Endocrinology & Metabolism, 20(3), pp.150~154 (2015), 대한소아내분비학회
- Pirker-Fruhauf UM, "Osteoporosis in children and young adults: a late effect after chemotherapy for bone sarcoma", Clin Orthop Relat Res, 470, pp.2874~2885 (2012)
- Hortobag yi GN, "Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. Protocol 19 Aredia Breast Cancer Study Group", J Clin Oncol, 16, pp.2038~2044 (1998)
- Terpos E, "Prognostic variables for survival and skeletal complications in patients with multiple myeloma osteolytic bone disease", Leukemia, 24, pp.1043~1049 (2010)
- Srivastava T, "The role of bisphosphonates in diseases of childhood", Eur J Pediatr, 162, pp.735~751 (2003)
- Sebestyen JF, "Bisphosphonates use in children", Clin Pediatr (Phila), 51, pp.1011~1024 (2012)
- Sonnemann J, "The bisphosphonate pamidronate is a potent inhibitor of human osteosarcoma cell growth in vitro", Anticancer Drugs, 12, pp.459~465 (2001)
- Ory B, "Zoledronic acid suppresses lung metastases and prolongs overall survival of osteosarcoma-bearing mice", Cancer, 104, pp.2522~2529 (2005)
- Lim JS, "Bone mineral density according to age, bone age, and pubertal stages in korean children and adolescents", J Clin Densitom, 13, pp.68~76 (2010)
- Ruza E, "Bone mineral density and bone metabolism in children treated for bone sarcomas", Pediatr Res, 59, pp.866~871 (2006)
- Müller C, "Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients", BMC Musculoskelet Disord, 11, pp.287~ (2010)
- Stanisavljevic S, "Fractures in children treated with methotrexate for leukemia", Clin Orthop Relat Res, (125), pp.139~144 (1977)
- Bonjour JP, "Pubertal timing, bone acquisition, and risk of f racture t hroughout life", Endocr Rev, 35, pp.820~847 (2014)
- Cooper C, "Review: developmental origins of osteoporotic fracture", Osteoporos Int, 17, pp.337~347 (2006)
- Glorieux FH, "Cyclic administration of pamidronate in children with severe osteogenesis imperfecta", N Engl J Med, 339, pp.947~952 (1998)
- Shaw NJ, "Intravenous pamidronate in juvenile osteoporosis", Arch Dis Child, 83, pp.143~145 (2000)
- Henderson RC, "Bisphosphonates to treat osteopenia in children with quadriplegic cerebral palsy:a randomized, placebo-controlled clinical trial", J Pediatr, 141, pp.644~651 (2002)
- Cimaz R, "Changes in markers of bone turnover and inflammatory variables during alendronate therapy in pediatric patients with rheumatic diseases", J Rheumatol, 29, pp.1786~1792 (2002)
- Nguyen T, "Pamidronate treatment of steroid associated osteonecrosis in young patients treated for acute lymphoblastic leukaemia--two-year outcomes", J Pediatr Endocrinol Metab, 19, pp.161~167 (2006)
- Meyers PA, "Addition of pamidronate to chemotherapy for the treatment of osteosarcoma", Cancer, 117, pp.1736~1744 (2011)
- Batch JA, "Use of bisphosphonate therapy for osteoporosis in childhood and adolescence", J Paediatr Child Health, 39, pp.88~92 (2003)
- Gandrud LM, "Low-dose intravenous pamidronate reduces fractures in childhood osteoporosis", J Pediatr Endocrinol Metab, 16, pp.887~892 (2003)
- 이지은, "소아청소년기 이차성 골다공증 환자에서의 파미드로네이트 치료", Annals of Pediatirc Endocrinology & Metabolism, 16(3), pp.178~184 (2011), 대한소아내분비학회
- Bachrach LK, "Clinical review 1: Bisphosphonate use in childhood osteoporosis", J Clin Endocrinol Metab, 94, pp.400~409 (2009)
- Lajer H, "Cisplatin and hypomagnesemia", Cancer Treat Rev, 25, pp.47~58 (1999)
- Reddy CR, "Studies on mechanisms of hypocalcemia of magnesium depletion", J Clin Invest, 52, pp.3000~3010 (1973)
- Ward L, "Bisphosphonate therapy for children and adolescents with secondary osteoporosis", Cochrane Database Syst Rev, (4), pp.CD005324~ (2007)