Pamidronate improves the quality of life and induces clinical remission ofbone metastases in patients with thyroid cancer

Skeletal metastases from thyroid cancer are poorly responsive to medical or radioiodine treatment. Bone destruction in skeletal metastases results fro m osteoclast-induced bone resorption. Therefore, a new approach in the ther apy of bone metastases consists in using aminobisphosphonates, such as pami dronate, which are potent inhibitors of osteoclastic activity. In the prese nt study, 10 thyroid cancer patients with painful osteolytic bone metastase s were administered pamidronate (90 mg, as a 2 hour intravenous infusion) m onthly for 12 consecutive cycles. Bone pain, quality of life, performance s tatus, analgesic consumption and disease staging were evaluated before and during the trial. The patients who had been administered pamidronate showed a significant decrease in bone pain (P = 0.0052). Performance status impro ved nearly significantly (P = 0.051), while the quality of life showed a re markable amelioration. However, no significant decrease in analgesic consum ption was recorded. Partial radiographic response of bone lesions was obser ved in 2/10 patients. The side effects of pamidronate were mild and transie nt. In conclusion, monthly infusion. of pamidronate is a well-tolerated tre atment that induces significant relief from bone pain and improves the qual ity of life of thyroid cancer patients with symptomatic and osteolytic bone metastases. (C) 2001 Cancer Research Campaign.