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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2006 April;165(2):63-6
Calcitonin administration for the treatment of metastatic bone pain in patients with prostate cancer
Koukos A., Kotakidis G., Triantaphyllidis I., Arealis G., Chatzimaliakas P., Koukos C.
Departments of Orthopedics and Urology, E.Dimitriou Hospital of Florina,Greece, Orthopedics Department, Hellenic Red Cross Hospital Athens, Greece
Aim. Metastatic bone disease is frequently a challenging source of pain for patients with prostate cancer. The purpose of our study is to evaluate the analgesic efficacy of intravenously and intramuscularly administered salmon calcitonin in comparison to that of the usual nonopioid and opioid analgesics when administered to patients with bone metastases from prostate cancer.
Methods.We evaluated 24 patients who underwent surgery for prostate cancer and postoperatively developed diffuse bone pain secondary to metastases. The patients were treated with intravenous and intramuscular administration of salmon calcitonin. The usual analgesics have a little or no effect over pain control in patients with bone metastases from prostate cancer. Their analgesic action lasts 3-4 hours, their effectiveness varies among patients and it is decreased by the time. The hormone calcitonin has the potential to relieve bone pain and achieve significant analgesia. We treated all the patients with 200 IU of salmon calcitonin per day-100 IU at the morning and 100 IU at the noon- diluted in 500 ml of a saline solution. The infusion rate was 50 drops per minute.
Results. All the patients treated with salmon calcitonin had a significant reduction of their pain by the second day of the administration. Especially in some patients, the reduction was considerable enough to allow their early mobilization.
Conclusion. The results of our study indicate a significant reduction of pain in about 70% of the patients when they were treated with calcitonin. On the contrary, there was a little or no relief of the pain experienced by the patients when they were treated with usual analgesics, even with opioids.
However, it is necessary to perform a trial with larger sample size in order to clarify the long term analgesic action of calcitonin on patients with painful bone metastases.