Ibandronate in the treatment of prostate cancer associated painful osseous metastases.

The aim of our study was to assess the clinical efficacy and toxicity of ibandronate in the management of symptomatic skeletal metastases due to prostate cancer (PCA). Twenty-five patients with painful osseous metastases due to hormone refractory PCA (HRPCA) were treated with 6 mg ibandronate every 4 weeks in an open prospective non-randomized clinical study. Primary study endpoint was pain reduction documented by the use of a 10-point visual analog scale. Palliative response with significant reduction in pain score from 6.5 (5-10) to 2.0 [(0-4), P<0.001] was achieved in 23 (92%) patients; nine patients (39%) were completely pain free. Bisphosphonate treatment of painful osseous metastases due to HRPCA resulted in a significant pain reduction and a significant decrease of daily consumption of analgesics in 92% of the patients. Both characteristics are paralleled by an increase in Karnofsky index mainly due to better mobility. Bisphosphonates should have a definite role in the palliative management of symptomatic HRPCA.