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A prospective randomized controlled clinical trial of zoledronic acid for bone metastases

Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, University of Athens, Athens, Greece

Emmanuela Katsouda, MD

Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, University of Athens, Athens, Greece

Efi Parpa, BA, MA

Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, University of Athens, Athens, Greece

Evangelia Kouskouni, MD, PhD

Department of Microbiology, Areteion Hospital, University of Athens, Athens, Greece

Costas Chondros, PhD

Department of Microbiology, Areteion Hospital, University of Athens, Athens, Greece

Marinos L. Tsiatas, MD, PhD

Department of Clinical Therapeutics, Areteion Hospital, University of Athens, Athens, Greece

Antonis Galanos, BSc

Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, University of Athens, Athens, Greece

Lambros Vlahos, MD, PhD

Pain Relief and Palliative Care Unit, Department of Radiology, University of Athens, Athens, Greece

In this study, we assessed the safety, tolerability, and effectiveness of two therapeutic regimens relating to the frequency of zoledronic acid (ZOL) infusion. Sixty adult patients with bone metastases were randomly assigned to two study groups. The first group (group A) received 4 mg ZOL every two weeks, and the second group (group B) received 4 mg ZOL every four weeks. Assessment measures included C-telopeptide (CTX) rate, the Greek Brief Pain Inventory (GBPI), the linear analogue scale assessment (LASA) of quality of life, and biochemical markers. Assessments were made at weeks 12, 24, 36, and 48. Clinical endpoints included effective decrease in bone resorption markers, pain relief, and improvement of mobility status. The follow-up period was 48 weeks. No statistically significant differences between groups A and B were found in overall profile of biochemical markers, Eastern Cooperative Oncology Group (ECOG) performance status, and GBPI score at the end of the follow-up period. Assessment of bone metastases revealed a slight difference between the two groups, however this difference was not statistically significant. These findings indicate that administering zoledronic acid at four rather that two weeks has no significant impact on overall outcome.

Key Words: palliative • zoledronic acid • bone metastases • mobility status

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 1, 41-50 (2006)
DOI: 10.1177/104990910602300107


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