The Implication of Ibandronic Acid in Treatment on Bone Metastatic Disease in Lung-Cancer Patients at RSUP Persahabatan

Background: Bone metastasis (BM) is one of the problems in lung cancer because it affects the prognosis and quality of life. The management of BM in lung-cancer are treatment of primary cancer lesion, radiotherapy on the metastatic lesions and ibandronic acid. The aim of study was to evaluate the efficacy of ibandronic acid in the treatment of cancer pain caused by BM. Methods: In this retrospective study with the subjects were lung cancer patients with BM and treated in Persahabatan Central General Hospital between January 1st 2016 and June 30th 2018 were enrolled. All of patients received ibandronic acid 6 mg (intravenously) monthly and Visual Analogue Scale (VAS) was used to evaluate pain. All patients received other management cancer pain such as analgesics, radiotherapy or combination. Results: Most BM lesions (51 subjects) were in vertebra 74 subjects (43.79%), thoracic cage 55 subjects (32.54%) and pelvic 28 subjects (17.75%). The averages of given of ibandronic acid 6 mg intravena was 8 times with the time-to-treat of ibandronic acid since the first time of lung cancer diagnosis was 6 months. VAS pain scale after given of ibandronic acid was classified to mild pain 14 cases (27.54%), moderate pain 37 subjects (72.46%) and severe pain 0 subject (0.00%). Overall the decrease in VAS scale was seen after 4 times ibandronic acid was given. Pain was significantly decrease after 5 times given in patients which mild-moderate pain and was significantly on severe pain group (P=0.0001). The side effects caused by ibandronic acid was observed in 9 subjects, in which 2 subjects (3.9%) had a rash skin, 3 subjects (5.9%) suffered nausea and vomiting, 3 subjects (5.9%) had headache, and 1 subject (2.0%) fever. Conclusions: Ibandronic acid treatment was useful to relieve metastatic bone pain in lung cancer patients.