title: Zoledronic acid in the treatment of bone metastases by hepatocellular carcinoma: a case series.
abstract: OBJECTIVE
  The survival of patients with hepatocellular carcinoma (HCC) has improved with advancements in various diagnostic tools and treatment modalities. Consequently, bone metastases from HCC are diagnosed more frequently. The aims of the present study was to describe the clinical features and treatment of HCC patients presenting with bone metastases. In particular, we evaluated the role of zoledronic acid in these patients especially with regard to pain reduction, analgesic drug consumption and safety.
  
  
  METHODS
  Between December 2006 and July 2008, we recruited 17 (male:female, 12:5, median age, 68 years; age range, 62-85 years) consecutive patients. Spinal metastases were present in 11 patients (64.7%). Zoledronic acid was administered in all patients (total number of administrations, 107; mean number of administrations, 6.29).
  
  
  RESULTS
  A total of 15 patients received at least three administrations of zoledronic acid and reported clinical benefit with pain reduction and tapering of analgesic drugs. Before starting treatment, the mean VAS for patients who received at least three administrations (15/17 patients) of zoledronic acid was 7.1 (+/-0.24), and after 3 months 5.3 (+/-0.20). This improvement was independent of the sex, the extent of metastasis and the concomitant anticancer treatment. No significant side effects were registered in this series of patients. Median survival was 10 months (CI 6,353-13,647).
  
  
  CONCLUSIONS
  Zoledronic acid may be helpful in treating bone metastases in HCC patients. Patients regularly receiving zoledronic acid showed significant pain relief.
authors.affiliation: Medical Oncology Unit, San Giovanni di Dio Hospital, via Domenico Pirozzi, Frattamaggiore, Naples, Italy. lilianamontella@libero.it
authors.forename: Liliana
authors.initials: L
authors.lastname: Montella
authors.forename: Raffaele
authors.initials: R
authors.lastname: Addeo
authors.forename: Giovannella
authors.initials: G
authors.lastname: Palmieri
authors.forename: Michele
authors.initials: M
authors.lastname: Caraglia
authors.forename: Gregorio
authors.initials: G
authors.lastname: Cennamo
authors.forename: Bruno
authors.initials: B
authors.lastname: Vincenzi
authors.forename: Rosario
authors.initials: R
authors.lastname: Guarrasi
authors.forename: Rosanna
authors.initials: R
authors.lastname: Mamone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Faiola
authors.forename: Nicola
authors.initials: N
authors.lastname: Frega
authors.forename: Elena
authors.initials: E
authors.lastname: Capasso
authors.forename: Luigi
authors.initials: L
authors.lastname: Maiorino
authors.forename: Davide
authors.initials: D
authors.lastname: Leopardo
authors.forename: Carmine
authors.initials: C
authors.lastname: Pizza
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Montesarchio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Del Prete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid