Efficacy of pamidronate in pediatric osteosarcoma patients with low bone mineral density.
OBJECTIVE
Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients.


METHODS
Nine osteosarcoma patients (12.8±1.6 years of age; 5 boys and 4 girls) who had a history of nontraumatic fracture or severe pain after completing chemotherapy were included. Intravenous pamidronate (1.5 mg/kg) was given every 6 weeks for 4 to 6 cycles. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy x-ray absorptiometry. Clinical outcomes including acute side effects were also evaluated.


RESULTS
After pamidronate treatments, all patients experienced decreased pain. Seven of 9 patients could walk without a crutch. The BMD of lumbar spine was increased by 0.108±0.062 mg/cm(2) after 8.4±1.0 months (n=8, P=0.017) and the mean z-score improved from -2.14±0.94 to -1.76±0.95 (P=0.161). Six patients (67%) had an acute-phase reaction, and 2 patients had symptomatic hypocalcemia.


CONCLUSIONS
Pamidronate appears to be safe and effective for the treatment of osteosarcoma in children with low BMD and bone pain.
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Se Won
SW
Lim
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Ju Hyun
JH
Ahn
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Aery
A
Choi
Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea.
Wan Hyeong
WH
Cho
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Jun Ah
JA
Lee
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Dong Ho
DH
Kim
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Ju-Hee
JH
Seo
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Jung Sub
JS
Lim
Bone mineral density; Child; Osteosarcoma; Pamidronate