Combination ibandronate and radiotherapy for the treatment of bone metastases: clinical evaluation and radiologic assessment

Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):264-72. doi: 10.1016/j.ijrobp.2006.08.022. Epub 2006 Nov 2.

Abstract

Purpose: 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 and materials: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analgesics, Opioid / therapeutic use
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Diseases / drug therapy
  • Bone Diseases / radiotherapy
  • Bone Neoplasms* / drug therapy
  • Bone Neoplasms* / radiotherapy
  • Bone Neoplasms* / secondary
  • Combined Modality Therapy / methods
  • Diphosphonates / adverse effects
  • Diphosphonates / therapeutic use*
  • Female
  • Humans
  • Ibandronic Acid
  • Infusions, Intravenous
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pain / drug therapy*
  • Pain / radiotherapy*
  • Pain Measurement
  • Pilot Projects
  • Prospective Studies
  • Statistics, Nonparametric

Substances

  • Analgesics, Opioid
  • Bone Density Conservation Agents
  • Diphosphonates
  • Ibandronic Acid