Metástases ósseas: opções de tratamento sistêmico
DOI:
https://doi.org/10.32635/2176-9745.RBC.1995v41n2.2932Palabras clave:
Metástases Ósseas, Tratamento Sistêmico, Radioisótopos, Nitrato De Gálio, BifosfonatosResumen
As metástases ósseas podem ser um dos primeiros indicativos de doença disseminada nos pacientes com câncer, principalmente de mama, pulmão e próstata. Embora a maior parte desses pacientes tenha sua sobrevida diminuída após o diagnóstico de doença metastática, uma proporção considerável sobreviverá por um período de tempo suficientemente grande para que a doença óssea provoque sintomas significativos, causando dor e afetando a qualidade de vida do indivíduo. Alternativas de tratamento vêm sendo pesquisadas para esses pacientes, em tentativas de interferência no processo fisiopatológico da doença óssea. Radioisótopos e agentes sem atividade citotóxica têm se destacado neste aspecto, e este artigo sobrepassa as diversas alternativas terapêuticas em investigação clínica para esse grupo de pacientes.
Descargas
Citas
NIELSEN, OS.; MUNRO, A.J.; TANNOCK, l.F. – Bone metastases: pathaphysiology and management policy. J Clin Oncol, 9(3)509-24, 1991. DOI: https://doi.org/10.1200/JCO.1991.9.3.509
STOLL, B.A. - Natural history, prognosis, and staging of bone metastases. In: STOLL, B.A.; PARBHOO, S. (eds). Bone metastases: monitoring and treatment. New York, NY, Raven, pp 1-20, 1983.
MALAWER, MM.; DELANEY, T.F. - Treatment of metastatic cancer to bone. in: DE VITA, V.T.Jr; HELLMAN, S. & ROSENBERG, S.A. (eds). Cancer: principles and practice of oncology, Philadelphia, PA, Lippincott, pp 2225-2245, 1993.
HARRIS, J.R.; MORROW, M.; BONADONNA, G. - Cancer of the breast. In: DE VITA, V.T.Jr; HELLMAN, S. & ROSENBERG, S.A. (eds). Cancer: principles and practice of oncolagy, Philadelphia, PA, Lippincott, pp 1264-1332, 1993.
HANKS, G.E.; MYERS, C.E.; SCARDIUNO, P.T. - Cancer of the prostate. In: De Vita, V.T.Jr; Hellman, S. & Rosenberg, S.A. (eds). Cancer: Principies and Practice of Oncology, Philadelphia, PA, Lippincott, pp 1073-1113, 1993.
CRAWFORD, E.D.; EISENBERGER, M.A.; MCLEOD, D.G. et al - A controlled trial of leuprolide with and without flutamide in prostatic carcinoma. N Engi J Med, 321:419-24, 1989. DOI: https://doi.org/10.1056/NEJM198908173210702
HIDE, D.C.; PASS, H.l.; GLATSTEIN, E.J. - Smal cell lung cancer. In: DE VITA, VT.Jr; HELLMAN, S. & ROSENBERG, S.A. (eds). Cancer: principles and practice of oncology, Phiiadelphia, PA, Lippincott, pp 723-30, 1993.
ROBINSON, R.G. - Strantium-89: Precursor targeted therapy for pain relief of blastic metastatic disease. Cancer, 723433-35, 1993. DOI: https://doi.org/10.1002/1097-0142(19931201)72:11+<3433::AID-CNCR2820721609>3.0.CO;2-I
PORTER, A.T.; MCEWAN, A.J.B.; POWE, J.E.; REID, R.H.; MCGOWEN, DC.; LUKKA, H. et al. - Results of a randomized phase-IIl trial to evaluate the efficacy of strontium-89 adjuvant to local field external beam irradiation in the management of endocrine resistant metastatic prostate cancer. Int J Radiat Oncol Biol Phys, 25. 805-13, 1993. DOI: https://doi.org/10.1016/0360-3016(93)90309-J
FARHANGI, M.; HOLMES, R.A.; VOLKERT, W.A.; LOGAN, W.; SINGH, A. - Samarium-153-EDTMP: farmacokinetic, toxicity and pain response using escalating dose schedule in treatment of metastatic bone cancer. J Nucl Med, 33.1451-8, 1992.
MAXON, H.R.l.; SCHRODER, L.E.; HERTZBERG, V.S.; THOMAS, S.R.; ENGLARO, E.E.; SAMARATUNGA, R. et al. - Rhenium-186-HEDP for treatment of painful osseaus metastases: results of a double-blind cross-over comparison with placebo. J Nuci Med, 32:1877-81, 1991.
BOCKMAN, R.S.; BOSKEY A.; BLUMENTHAL, N.C. et al. - Gallium increases bone calcium and crystallite perfection of hydroxyapatite. Calcif Tissue Int, 39376-81, 1986. DOI: https://doi.org/10.1007/BF02555174
WARREL, R.P.; ALCOCK, N.W.; BOCKMAN, R.S. - Gallium nitrate inhibits accelerated bone turnover in patients with bane metastases. J Clin Oncol, 5(2)292-8, 1987. DOI: https://doi.org/10.1200/JCO.1987.5.2.292
WARREL, R.P.; LOVETT, D; DILLMANIAN, F.A.; SCHNEIDER, R.; HEELAN, R.T. - Low-dose gallium nitrate for prevention of osteolysis in myeloma: results of a pilot randomized study. J Clin Oncol, 11(12):2443- 50, 1993. DOI: https://doi.org/10.1200/JCO.1993.11.12.2443
AVERBUCH, S.D. - New bisphosphonates in the treatment of bone metastases. Cancer, 723443-52, 1993.
SMITH, J.A. - Palliation of painful bone metastases from prostate cancer using sodium etidronate: results of a randomized, prospective double-blind, placebo-controlled study. J Urol, 141:85-7, 1989. DOI: https://doi.org/10.1016/S0022-5347(17)40597-0
LAHTINEN, R.; LAAKSO, M.; PALVA, I.; VIRNUKKEN, P.; ELOMAA, I. - Randomized, placebo-controlled multicentre trial of clodronate in multiple myeloma. Lancet, 340:1049-52, 1992. DOI: https://doi.org/10.1016/0140-6736(92)93075-X
PATERSON, A.H.G.; POWLES, T.J.; KANIS, J.A.; MCCLOSKEY, E.; HANSON, J.; ASHLEY, S. - Double-blind controlled trial of oral clodronate in patients with bone metastases from breast cancer. J Clin Oncol, 11(1):59-65, 1993. DOI: https://doi.org/10.1200/JCO.1993.11.1.59
VAN HOLTEN-VERZANTVOORT, A.T.M.; KROON, H.M.; BIJVOET, F.J.; CLETON, L.V.A.M. et al.-Palliative pamidronate treatment in patients with bone metastases from breast cancer. J Clin Oncol, 11(3)491-8, 1993. DOI: https://doi.org/10.1200/JCO.1993.11.3.491
