R.N. Safin1, I.R. Safin1,2, R.Sh. Khasanov2, A.Yu. Rodionova1, R.M. Maksutova1, A.R. Amirova3
1Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after prof. M.Z. Sigal, Kazan
2Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan
3Kazan State Medical University, Kazan
Safin Rustem N. ― oncologist, head of chemotherapy department №1 of the Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after prof. M.Z. Sigal
29 Sibirskiy Trakt, Kazan, 420029, Russian Federation, tel. +7-917-272-79-93, e-mail: rustem1408@mail.ru, ORCID ID: 0000-0003-0585-7727
Abstract. Currently, a personalized approach is considered a priority in the treatment of malignant neoplasms. The combination of various treatment methods (surgery, drug antitumor therapy, radiation therapy) can significantly improve patient survival and provide them with an optimal quality of life. However, due to the peculiarities of the course of the tumor process and/or the action of drugs, cancer patients often develop bone pathology. Bone pathology that develops in cancer patients includes osteoporosis, metastatic bone damage, and bone damage in plasma cell myeloma. Osteoporosis develops in 10% of cases and is most often associated with menopause (both physiologically and surgically induced) and drug antitumor treatment. Bone metastases are present in 40% of cancer patients, the most common cause of skeletal damage is the progression of breast cancer, prostate cancer, kidney cancer, lung cancer. In 5-30% of cases, bone metastases are complicated by the development of a pathological fracture. The next, quite common, cause of bone tissue destruction is plasma cell myeloma, which accounts for 1% of the structure of all malignant neoplasms. Plasma cell myeloma is often accompanied by the development of pathological bone fractures, hypercalcemia, and kidney damage. Skeletal complications developing against the background of osteoporosis and tumor destruction of bone tissue significantly worsen the prognosis of cancer and do not allow the continuation of specialized antitumor treatment. Given this circumstance, an important task of accompanying therapy in the treatment of malignant neoplasms is the correction of bone tissue in cancer patients, which will ensure the prevention of skeletal complications and control of pain syndrome. For this purpose, osteomodifying agents are used, including various groups of drugs, of which bisphosphonates and denosumab are the most important. These drugs are widely used in bone damage in cancer patients. Indications for use, contraindications, features and forms of administration of osteomodifying drugs differ, and therefore the choice of the drug is personalized. However, a common feature of all osteomodifying drugs is that their effectiveness in preventing skeletal complications has been confirmed by scientific research.
Key words: osteoporosis, bone metastases, plasma cell myeloma, skeletal complications.