Comparative clinical and laboratory outcomes of zoledronic acid and ibandronic acid chemotherapy in patients with secondary spinal metastasis from primary breast carcinoma

Spinal carcinoma or metastasis is a mass that multiplies abnormally around the vertebral column and spinal cord and can cause various symptoms such as pain, tingling, and other complaints that can disrupt the patient's social and psychological function. There are two types of spinal metastasis, namely primary and secondary. Spine metastasis is often caused by visceral organ metastases. The most common secondary type, one source of metastases to the spine comes from the breast, prostate, lungs, kidneys and thyroid. The thoracic region is the most common site for metastases (70%) followed by lumbosacral (16-22%) and cervical (8-15%). Zoledronic acid and ibandronat are considered to be new alternatives in preventing tumor compression in the spine, so clinical and laboratory evaluation is important This study was a study with a purposive sampling design in patients after chemotherapy with zoledronic acid or ibandronic acid in patients with secondary spinal metastases with primary breast carcinoma who were admitted to the orthopedic surgery and oncology surgery clinic at Soetomo Regional Hospital. Clinical evaluation was carried out using the KPS questionnaire, SF-36, SOSGOQ, and laboratory evaluation using Ca15-3 and serum calcium levels. In the age range 41-50, the number of spine metastases is higher compared to other age ranges. The average KPS score when administering zoledronate and ibandronate therapy was (75 ± 18.95, 67.5 ± 26.19). The average SF-36 score when administering zoledronate and ibandronate therapy was (69.4 ± 22.71, 44.3 ± 29.68). The average SOSGOQ score when administering zoledronate and ibandronate therapy was (69.16 ± 21.54, 53.54 ± 27.64). While the improvement in quality of life measured by the KPS score was not statistically significant (p = 0.539), the differences were significant when measured by the SF-36 (p = 0.004) and SOSGOQ scores (p = 0.013). This clinical assessment was supported by laboratory assessments, showing significant result in decreasing Delta Ca 15-3 and Calcium Serum in Ibandronat than Zoledronat (p=0,013; p=0,017). Based on the results of the existing research characteristics and all questionnaires, it shows that the administration of zoledronic acid therapy shows a higher score compared to the administration of ibandronic acid therapy, there is no significant effect on the administration of therapy on Ca15-3 and blood calcium levels.