Abstract:
:Introduction: Bisphosphonates are well known above all for their use in the treatment of osteoporosis. They also play an important role as accompanying therapy for advanced tumour diseases with extensive spread into the skeletal system. Their adjuvant use in the treatment of breast cancer without bony metastases is currently a subject of controversial discussion. The objective of the present evaluation is to describe the use of bisphosphonates in the therapy for breast cancer. We will show how frequently bisphosphonates are used, which bisphosphonates are preferred and what specific features patients under bisphosphonate therapy exhibit. Methods and Materials: The pseudonymous data set from the biobank of the German PATH foundation was used for the evaluation. From the total collective, 2492 patients were selected after consideration of the inclusion and exclusion criteria. The selected patient collective was divided into two groups (with and without bisphosphonate therapy) and the two groups compared with one another with the help of descriptive statistics. Results: 17.5 % of the 2492 patients had prescriptions for a bisphosphonate as part of their therapy. The most frequently administered bisphosphonate was zoledronate. Pathological (induced by tumour therapy) osteoporosis was the most frequently stated indication among the bisphosphonate patients, followed by consumption starting prior to the breast cancer therapy and treatment of bony metastases. Patients under bisphosphonate and antihormonal therapy frequently received an aromatase inhibitor as the active principle in the antihormonal therapy whereas patients under antihormonal therapy but without bisphosphonates more frequently received tamoxifen as active principle. Ten of the 2492 patients reported receiving bisphosphonate therapy as prophylaxis for bony metastases without a documented and approved indication. Use of bisphosphonates in the course of the GAIN, ICE, SUCCESS or, respectively, NATAN trials was reported by 29 of the 2492 patients. Conclusions: In the PATH collective, bisphosphonates were employed above all for the treatment of (tumour therapy-induced) osteoporosis and bony metastases. Off-label use and participation in clinical trials played only a minor role in this patient collective. Against the background of the uncertain data status for the adjuvant use of bisphosphonates, the development (and use) of standardised, validated questionnaires to record the indications for and frequency of use of bisphosphonate therapy is recommended. ZUSAMMENFASSUNG:Einleitung: Die Bisphosphonate sind vor allem für ihren Einsatz bei der Behandlung einer Osteoporose bekannt. In der Therapie des Mammakarzinoms spielen sie als begleitende Therapie bei fortgeschrittenen, auf das Skelett ausgedehnten Tumorerkrankungen eine wichtige Rolle. Kontrovers diskutiert wird zurzeit der adjuvante Einsatz bei primären Brustkrebserkrankungen ohne ossäre Metastasen. Das Ziel dieser Auswertung ist es, den Einsatz der Bisphosphonate in der Therapie des Mammakarzinoms zu beschreiben. Es soll gezeigt werden, wie oft die Bisphosphonate eingesetzt werden, welche Bisphosphonate bevorzugt eingesetzt werden und welche besonderen Merkmale Patientinnen mit einer Bisphosphonattherapie aufweisen. Methoden und Materialien: Für die Auswertung wurde der pseudonymisierte Datensatz aus der Biobank der deutschen Stiftung PATH verwendet. Aus dem Gesamtkollektiv wurden unter Berücksichtigung der Ein- und Ausschlusskriterien 2492 Patientinnen ausgewählt. Das ausgewählte Patientenkollektiv wurde in 2 Gruppen (mit und ohne Bisphosphonattherapie) aufgeteilt und mithilfe der deskriptiven Statistik miteinander verglichen. Ergebnisse: 17,5 % der 2492 Patientinnen wurde im Rahmen der Therapie ein Bisphosphonat verordnet. Das am häufigsten eingesetzte Bisphosphonat war Zoledronat. Die pathologische (tumortherapieinduzierte) Osteoporose war die am häufigsten genannte Indikation unter den Bisphosphonat-Patientinnen, gefolgt von der Einnahme bereits vor der Brustkrebstherapie und der Behandlung von Knochenmetastasen. Patientinnen mit Bisphosphonat- und Antihormontherapie erhielten häufiger einen Aromatasehemmer als Wirkstoff der Antihormontherapie, während Patientinnen mit einer Antihormontherapie, aber ohne Bisphosphonattherapie häufiger Tamoxifen als Wirkstoff erhielten. Eine Bisphosphonattherapie zur Vorbeugung von Knochenmetastasen ohne dokumentierte, zugelassene Indikation berichteten 10 von 2492 Patientinnen. Der Bisphosphonateinsatz im Rahmen der GAIN-, ICE-, SUCCESS- bzw. NATAN-Studie wurde von 29 der 2492 Patientinnen berichtet. Schlussfolgerungen: Im PATH-Kollektiv werden die Bisphosphonate vor allem für die Behandlung einer (tumortherapieinduzierten) Osteoporose und die Behandlung von Knochenmetastasen eingesetzt. Der Einsatz im Off-Label-Use und die Studienteilnahme spielt in diesem Patientenkollektiv eine untergeordnete Rolle. Vor dem Hintergrund der unsicheren Datenlage zum adjuvanten Einsatz der Bisphosphonate ist die Entwicklung (und Anwendung) standardisierter, validierter Fragebögen zur Erhebung der Frequenz und Indikation einer Bisphosphonattherapie zu empfehlen.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Fick EM,Anzeneder T,Katalinic A,Waldmann Adoi
10.1055/s-0032-1328502subject
Has Abstractpub_date
2013-05-01 00:00:00pages
412-421issue
5eissn
0016-5751issn
1438-8804journal_volume
73pub_type
杂志文章abstract::The diagnostic value of radiological pelvimetry is subject to controversial interpretation. This examination is being conducted at the Department of Gynaecology in Aarau (Frauenklinik Aarau) mainly in pregnant women in pelvic presentation or during the puerperium after Caesarean section. Based on 164 radiological pelv...
journal_title:Geburtshilfe und Frauenheilkunde
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abstract::Contaminants exercise an influence on different levels of reproduction, resulting in disturbances of the cycle, abortion and diverse complications during pregnancy among women, whereas, in the case of men, alterations of the spermiogram have been observed. Numerous unfavourable influences on reproduction are known fro...
journal_title:Geburtshilfe und Frauenheilkunde
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doi:10.1055/s-2007-1023171
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abstract::A study of the side effects of epidural anesthesia for painless delivery in 100 patients showed that 90% of the post partum patients were very satisfied with the analgesia and did not consider symptoms post partum to be very debilitating and did not blame the epidural anesthesia for the symptoms. Severe pain in the oc...
journal_title:Geburtshilfe und Frauenheilkunde
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abstract::Ten patients with gynecological problems were examined in the context of a preoperative discussion for informed consent. The Patients were tested before and following the discussion with questionnaires and partly standardized interviews regarding their condition and knowledge and the evaluation of the information styl...
journal_title:Geburtshilfe und Frauenheilkunde
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journal_title:Geburtshilfe und Frauenheilkunde
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journal_title:Geburtshilfe und Frauenheilkunde
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
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更新日期:1982-02-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036632
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journal_title:Geburtshilfe und Frauenheilkunde
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更新日期:1980-01-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
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doi:10.1055/s-2007-1023578
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035824
更新日期:1987-04-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035836
更新日期:1989-06-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036804
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journal_title:Geburtshilfe und Frauenheilkunde
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
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journal_title:Geburtshilfe und Frauenheilkunde
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