Objective To systematically evaluate the effectiveness and safety of zoledronic acid combined with radiotherapy in treating bone metastasis of malignant tumor. Methods Such databases as PubMed, EMbase, The Cochrane Library (Issue 10, 2012), CBM, CNKI, VIP and WanFang Data were searched to collect randomized clinical trials (RCTs) on bone metastasis of malignant tumor from inception to October, 2012. References of included studies were also retrieved. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.1 software. Results Twenty nine trials were included involving 2 021 patients. The results of meta-analysis showed that, compared with the radiotherapy alone group, zoledronic acid combined with radiotherapy improved the effectiveness rate of pain relieving at the end of treatment (OR=3.08, 95%CI 2.30 to 4.12, Plt;0.000 01), the effectiveness rate of pain relieving two weeks after treatment (OR=3.39, 95%CI 2.52 to 4.56, Plt;0.000 01), the quality of life (OR=2.74, 95%CI 1.66 to 4.52, Plt;0.000 01) and the ability of movement (OR=2.96, 95%CI 2.16 to 4.05, Plt;0.000 01). Zoledronic acid combined with radiotherapy also reduced the incidence of new bone metastasis (OR=0.21, 95%CI 0.10 to 0.45, Plt;0.000 1) and the incidence rate of bone-related events (OR=0.17, 95%CI 0.03 to 0.92, P=0.04). The adverse reactions of zoledronic acid combined with radiotherapy such as fever (OR=11.92, 95%CI 6.31 to 22.48, Plt;0.000 01) and hypocalcaemia (OR=8.82, 95%CI 1.61 to 48.36, P=0.01), significantly increased. Conclusion Compared with radiotherapy alone, zoledronic acid combined with radiotherapy can relieve bone metastatic pain, effectively enhance patients’ ability of movement, improve quality of life, and decrease new bone metastasis and the occurrence of bone-related events.
ObjectiveTo observe the treatment effects of zoledronic acid on postmenopausal osteoporosis. MethodsSeventy-two postmenopausal osteoporosis patients from July 2007 to December 2010 were randomly divided into observation group and control group, with 36 patients in each. Traditional drug treatment was used in the control group, while traditional drug treatment and zoledronic acid were used for patients in the observation group. The Indicator of bone mineral density (BMD) and ostocalcin were used to comapre the treatment effects between the two groups after one-year treatment. ResultsThere was a significant difference in BMD and osteocalcin in both the observation group and the control group before and after treatment (P<0.05). The treatment effect is superior in the observation group (P<0.05). ConclusionZoledronic acid is an effective treatment for postmenopausal osteoporosis; it can increase BMD and osteocalcin more effectively.
ObjectiveTo study the preventive effect of zoledronic acid on the bone metastases of breast cancer. MethodsFour hundred and eighteen female patients with infiltrating ductal carcinoma who were underwent surgery in The First Affiliated Hospital of Xinjiang Medical University from Jan. 2006 to Dec. 2009 were collected and divided into 2 group, patients of prevention group accepted the preventive remedy of zoledronic acid(n=216), but patients of control group didn't accept(n=202). Comparison of incidence of bone metastases and recurrence was performed. ResultsThere were 37(17.13%) patients suffered bone metastases in prevention group and 73(36.14%) patients in control group, so the incidence of bone metastases was higher in control group(χ2=19.45, P<0.05). But there were no significant difference on incidence of pulmonary metastasis, liver metastases, other parts of metastases, multiple organ metastases, and recurrence(P>0.05). ConclusionZoledronic acid could significantly reduce the incidence of bone metastases for patients with breast cancer, who underwent chemotherapy of conventional dose after operation, and it can effectively improve the prognosis of patients with breast cancer.
ObjectiveTo systematically review the efficacy of zoledronic acid (ZOL) on postoperative osteoporosis vertebral fracture (OVFs) of patients undergoing percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).MethodsWe searched databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about ZOL on postoperative OVFs of patients undergoing PVP or PKP from inception to June 30th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.3 software was used for meta-analysis.ResultsA total of 11 RCTs involving 950 cases of OVFs were included. The results of meta-analysis showed that: the bone mineral densities of the ZOL group at 6 months (SMD=0.62, 95%CI 0.06 to 1.18, P=0.03) and 12 months (SMD=1.32, 95%CI 0.62 to 2.02, P=0.000 2) after the operation were higher than those of the control group. The re-fracture risk of the ZOL group was lower than that of the control group (RR=0.27, 95%CI 0.16 to 0.47, P<0.000 01). The visual analogue scales of the ZOL group were lower than those of the control group at 3 weeks (SMD=–1.03, 95%CI –1.42 to –0.63, P<0.000 01), 1 month (SMD=–1.57, 95%CI –2.30 to –0.83, P<0.000 01), 3 months (SMD=–1.53, 95%CI –2.20 to –0.86, P<0.000 01), 6 months (SMD=–2.59, 95%CI –3.42 to –1.76, P<0.000 01), and 12 months (SMD=–2.69, 95%CI –4.21 to –1.18, P=0.000 5) after the operation. In addition, Oswestry disability index (ODI) score of the ZOL group was better than that of the control group at 1 year after the operation (SMD=–1.61, 95% CI–2.42 to –0.81, P<0.000 1).ConclusionsThe current evidence shows that the usage of ZOL after PVP/PKP has better effects, it relieves the pain further, increases the quantity of bone significantly, ameliorates the BMD, reduces the incidence of re-fracture and improves the quality of life. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusion.