Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis: a single-institution report.
OBJECTIVE
Bone metastases are a common cause of morbidity in elderly patients with solid tumors and myeloma. We studied the safety and the effect of a new bisphosphonate, zoledronic acid (ZA), on pain and on quality of life (QoL) in elderly patients with bone metastases.


METHODS
From January 2004 to December 2005, we have enrolled elderly patients with bone metastasis for receiving ZA administration. Visual analog scale (VAS) and Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire were used to assess potential benefits of ZA therapy.


RESULTS
Eighty-six patients were included; the median age was 75.5 years. Before starting treatment, the mean VAS was 6.8 (+/-0.24), after three infusions 5.4 (+/-0.3), and after six courses 4.5 (+/-0.3) with a significant improvement of bone pain. Moreover, we found a statistically significant improvement of QoL measured by FACT-G questionnaire after six courses (p = 0.010). Median baseline and final value of serum creatinine were 0.73 and 0.72 mg/dl, respectively (p = 0.11); creatinine clearance was also normal for most patients. Osteonecrosis of the jaw was diagnosed in one patient who received a prolonged ZA treatment.


CONCLUSIONS
These data confirm the benefits of ZA on pain and QoL also in elderly patients with bone metastasis from solid tumors.
Addeo
Raffaele
R
UOC Oncologia, S Giovanni di Dio Hospital, ASL Napoli3 Via Giovanni XXIII 80020 Frattaminore, Naples, Italy. lelloaddeo@alice.it
Nocera
Vincenzo
V
Faiola
Vincenzo
V
Vincenzi
Bruno
B
Ferraro
Gabriella
G
Montella
Liliana
L
Guarrasi
Rosario
R
Rossi
Eugenio
E
Cennamo
Gregorio
G
Tonini
Giuseppe
G
Capasso
Elena
E
Santini
Daniele
D
Caraglia
Michele
M
Del Prete
Salvatore
S
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000556:secondary; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
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