THE EFFECT OF COMBINED INTRAVENOUS AND ORAL CLODRONATE TREATMENT ON BONE PAIN IN PATIENTS WITH METASTATIC PROSTATE-CANCER

Although osteosclerotic metastases are characteristic of prostate canc er, bone resorption is also accelerated. Clodronate is a specific inhi bitor of osteoclastic bone resorption and relieves bone pain of osteol ytic lesions in myelomatosis and breast cancer. The present open study included 16 prostate cancer patients who had painful bone metastases and who had failed hormonal therapy. Clodronate was given intravenousl y for six days (300 mg/day) followed by oral treatment for 21 days (32 00 mg/day). A clear pain relief was found in nine of the 16 (56 %) pat ients after intravenous administration. During the next three weeks wi th oral administration there was still pain reduction in five patients , while in three patients the pain increased. The treatment had no eff ect on conventional tumour markers but urinary hydroxyproline excretio n decreased, indicating reduced bone resorption. Clodronate offers an alternative for treating patients with painful metastases from prostat e cancer.