The Effectiveness of Bisphosphonate to Reduce Pain in Lung Cancer Patients with Bone Metastasis

Noni Novisari Soeroso; Freddy Panggabean; Setia Putra Tarigan; Fotarisman Zaluchu; Fannie Rizki Ananda

doi:10.3889/oamjms.2022.9288

Authors

Noni Novisari Soeroso Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara Hospital, Medan, Indonesia
Freddy Panggabean Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara Hospital, Medan, Indonesia
Setia Putra Tarigan Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara Hospital, Medan, Indonesia
Fotarisman Zaluchu Department of Epidemiology, Universitas Sumatera Utara, Medan, Indonesia
Fannie Rizki Ananda Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara Hospital, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.9288

Keywords:

Bisphosphonate, Bone metastasis, Non-small cell lung cancer, Cancer pain, Visual analog scale

Abstract

Background: Bisphosphonates (BPs) are commonly used as supportive therapy to prevent skeletal-related events in lung cancer patients with bone metastasis, including severe bone pain, hypercalcemia, and pathological fractures. The purpose of this study was to assess the effectiveness of bisphosphonate therapy to reduce pain in non-small cell lung cancer (NSCLC) patients with bone metastasis.

Methods: This was a cross-sectional study carried on 38 patients diagnosed with lung cancer based on cytology or histopathology findings. Radiological examination such as thoracic CT scan, bone survey, and bone scan was performed to determine bone metastasis. Multimodality therapy is carried out for lung cancer palliative therapy including chemotherapy, radiotherapy, and bisphosphonate therapy (zoledronic acid and ibandronate) as supportive therapy to reducing cancer pain. Pain was assessed using the Visual Analog Scale (VAS) determined by patients themselves. Statistical tests were performed by paired T-test in which p< 0.05 was considered significant.

Results: As many as 38 patients enrolled in this study consisting of 29 men (76.3%) and 9 women (23.7%). The subtype of adenocarcinoma was mostly found in 31 cases (81.58%) and 7 cases (18.42%) was Squamous Cell Carcinoma. Cancer pain was found in all patients. Measurement of pain prior to treatment showed that most patients had VAS level of 7-10. After bisphosphonate therapy, the VAS level significantly decreased to 1-3 (p<0.01).

Conclusion: Bisphosphonate therapy was proven to effectively decrease the severity level of cancer pain in lung cancer patients with bone metastasis.

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