Terapia Medica delle Metastasi Ossee

Le metastasi ossee rappresentano la più frequente sede di localizzazione secondaria da neoplasia della mammella (20-30%). Il trattamento medico delle metastasi ossee può essere effettuato con bifosfonati (ad es. pamidronato, zoledronato, ibandronato) [93] o denosumab [94].

L’utilizzo dei bifosfonati previene le complicazioni correlate all’apparato scheletrico, come fratture,

schiacciamenti, dolore ed ipercalcemia neoplastica. Il trattamento con bifosfonati deve essere iniziato preferibilmente in caso di lesioni ossee sintomatiche o a rischio di evento scheletrico avverso (lesioni litiche o miste), non deve essere effettuato per tutti i pazienti con lesioni secondarie ossee. La durata del trattamento con bifosfonati non dovrebbe superare i 24 mesi complessivi, in considerazione dei possibili effetti collaterali (tossicità renale, osteonecrosi della mandibola, fibrillazione atriale)[95]. Per l’integrazione della terapia medica delle metastasi ossee con la radioterapia, si rimanda al Capitolo 3.5.

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