EVALUATION OF THE EFFICIENCY OF COMBINED TREATMENT OF PATIENTS WITH BONE METASTASES FROM KIDNEY AND PROSTATE CANCER USING SYSTEMIC RADIATION AND TARGETED THERAPY
Аннотация
Background: To improve the effectiveness of treatment for multiple osteogenic metastases from kidney and prostate cancer by optimizing the combined use of systemic radiation therapy and osteomodifying agents. Methods: This study, conducted at the Department of Oncology, Samarkand State Medical University, Samarkand, Uzbekistan, analyzed observational data from 110 patients with morphologically verified malignant neoplasms of the urinary system and multiple osteogenic metastases. Patients were divided into three groups. Outcomes were evaluated using bone pain dynamics scales, the WHO analgesic scale, and the Karnofsky performance status. Results: Subjective pain reduction and improved general condition were observed in 56 (87.5%) patients. A decrease in analgesic frequency and dosage occurred in 50 (78.1%) patients, with 14 (21.8%) discontinuing analgesics entirely. Improved mobility was reported by 29 (45.3%) patients, while 35 (54.6%) reported regaining full mobility. The combination of bisphosphonates, Denosumab, and Samarium (153Sm) lexidronam (Oxabifor) increased three-year survival by 32.3% and five-year survival by 15.0% Conclusion: A new protocol for multiple osteogenic metastases was tested, adding Oxabifor and Denosumab to standard therapy, with positive results. When bisphosphonates are contraindicated or ineffective, the combination of Denosumab and Oxabifor is the recommended treatment. Keywords: Kidney cancer, prostate cancer, bone metastases, radiopharmaceutical therapy, systemic radiation therapy, Samarium (153Sm) lexidronam (Ox- abifor), Denosumab.