Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis: a single-institution report

Goals of work Bone metastases are a common cause of morbidity in elderly patients with solid tumors and myeloma. We studied the safety and the effect of a new bisphosphonate, zoledronic acid (ZA), on pain and on quality of life (QoL) in elderly patients with bone metastases. Materials and methods From January 2004 to December 2005, we have enrolled elderly patients with bone metastasis for receiving ZA administration. Visual analog scale (VAS) and Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire were used to assess potential benefits of ZA therapy. Results Eighty-six patients were included; the median age was 75.5 years. Before starting treatment, the mean VAS was 6.8 (+/- 0.24), after three infusions 5.4 (+/- 0.3), and after six courses 4.5 (+/- 0.3) with a significant improvement of bone pain. Moreover, we found a statistically significant improvement of QoL measured by FACT-G questionnaire after six courses (p=0.010). Median baseline and final value of serum creatinine were 0.73 and 0.72 mg/dl, respectively (p=0.11); creatinine clearance was also normal for most patients. Osteonecrosis of the jaw was diagnosed in one patient who received a prolonged ZA treatment. Conclusions These data confirm the benefits of ZA on pain and QoL also in elderly patients with bone metastasis from solid tumors