Effects of alendronate on bone metastases and hypercalcemia after surgery for hepatocellular carcinoma

Alendronate, a bisphosphonate compound, lowers serum calcium in patients wi th cancer-associated hypercalcemia through its inhibitory effect on bone re sorption and as a result symptoms associated with hypercalcemia improve. Th is study was carried out to investigate the effects of alendronate in patie nts with hypercalcemia due to bone metastasis of hepatocellular carcinoma ( HCC). Two patients were evaluated. Their corrected serum calcium and a-feto protein (AFP) levels and their computed tomography (CT), bone scintigraphy and magnetic resonance imaging (MRI) findings were evaluated before and dur ing alendronate treatment. After treatment, not only the corrected serum ca lcium levels but also AFP levels and bone pain decreased; in addition, the regression of the metastatic focus was noted in the MRI analysis. These tum or inhibitory effects of alendronate have not been reported in HCC before; and alendronate might serve to prevent bone metastases in patients with HCC . In conclusion, two patients who developed hypercalcemia associated with b one metastasis after surgery for HCC were treated with alendronate and they experienced alleviation of the pain due to bone metastasis, improvement of their quality of life and a marked decrease in AFP levels with tumor regre ssion.