Combination ibandronate and radiotherapy for the treatment of bone metastases: clinical evaluation and radiologic assessment.
OBJECTIVE
Ibandronate is a single-nitrogen, noncyclic bisphosphonate with proven efficacy for reducing metastatic bone pain. In this study, we assessed the palliative effects of combined ibandronate and radiotherapy.


METHODS
Forty-five patients with bone metastases from various solid tumors received external-beam radiotherapy, 30-40 Gy over 3-4.5, weeks combined with 10 cycles of monthly intravenous ibandronate, 6 mg.


RESULTS
After combined therapy, mean bone pain scores (graded from 0 to 10) were reduced from 6.3 at baseline to 0.8 after 3 months, with further reductions at later time points (all p < 0.001). Opioid use decreased from 84% of patients at baseline (38/45) to 24% (11/45) at 3 months, with further subsequent reductions (all p < 0.001). Mean performance status and functioning scores also significantly improved. Bone density (assessed by computed tomography scan) increased by 20% vs. baseline at 3 months, 46% at 6 months, and 73% at 10 months (all p < 0.001). Lesion improvement was also demonstrated by magnetic resonance imaging. Treatment was well tolerated with no renal toxicity.


CONCLUSIONS
In this pilot study, combined radiotherapy and ibandronate provided substantial bone pain relief and increased bone density. Computed tomography-based or magnetic resonance imaging-based evaluations offer objective methods for assessing therapeutic outcomes.
Vassiliou
Vassilios
V
Department of Radiotherapy, University of Patras Medical School, Patras, Greece.
Kalogeropoulou
Christine
C
Christopoulos
Christos
C
Solomou
Ekaterini
E
Leotsinides
Michael
M
Kardamakis
Dimitrios
D
D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001847:Bone Diseases / Q000188:drug therapy / Q000532:radiotherapy; D001859:Bone Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D003131:Combined Modality Therapy / Q000379:methods; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077557:Ibandronic Acid; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000532:radiotherapy*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D000701:Analgesics, Opioid; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077557:Ibandronic Acid