title: Characterization of bone metastases in patients with renal cell cancer.
abstract: OBJECTIVE
  To characterize the clinical features of bone metastases in patients with renal cell carcinoma (RCC) treated with interleukin-2 therapy. Bone lesions contribute to significant morbidity and mortality, and although present in up to half of patients with RCC, their behaviour and response to therapy have not been well characterized.
  
  
  METHODS
  We evaluated skeletal metastases in 19 patients with bone lesions who received either moderate- or high-dose interleukin-2 therapy. Data on bone disease, including location and number of bone lesions, need for bone-specific therapies and use of pain medications, were noted. The response of bone lesions to interleukin-2 was compared with the response of other systemic metastatic sites.
  
  
  RESULTS
  Skeletal metastases resulted in significant morbidity by causing pain (75%) and other complications requiring surgical and/or radiotherapeutic intervention (94%) before beginning interleukin-2 therapy. In most patients the response of bone lesions to interleukin-2 was similar to that in their other systemic sites. Treatment with interleukin-2 had no significant effect on the requirement for pain medication for bone pain. However, it may have prevented skeletal complications requiring surgery or radiotherapy. None of the patients had hypercalcaemia; there was no significant association between bone metastases and elevated alkaline phosphatase levels.
  
  
  CONCLUSIONS
  Skeletal metastases are a significant contributor to morbidity among patients with RCC. Bone lesions respond similarly to interleukin-2 therapy as other systemic sites. Bisphosphonates appear promising for these predominantly osteolytic lesions.
authors.affiliation: Comprehensive Cancer Center and Department of Medicine, Our Lady of Mercy Medical Center, New York Medical College, Bronx, New York, USA.
authors.forename: G U
authors.initials: GU
authors.lastname: Adiga
authors.forename: J P
authors.initials: JP
authors.lastname: Dutcher
authors.forename: M
authors.initials: M
authors.lastname: Larkin
authors.forename: S
authors.initials: S
authors.lastname: Garl
authors.forename: J
authors.initials: J
authors.lastname: Koo
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001847:Bone Diseases / Q000209:etiology / Q000517:prevention & control; D001859:Bone Neoplasms / Q000556:secondary*; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal