A Case Report on Zoledronic Acid as Palliative Treatment in Carcinoma of Lung with Bone Metastasis

Bone metastasis is a general complication of advanced carcinomas, usually seen in breast cancer, prostate cancer, non-small cell lung cancer and multiple myeloma. Zoledronic acid, which belongs to bisphosphonates, is indicated for bone metastasis caused due to carcinomas. This case report is about a patient with carcinoma of lung (Stage 4) with bone metastasis who has been provided with zoledronic acid as a palliative treatment. The patient was a 65-year-old male with the known case of type 2 diabetes mellitus (T2DM) and ischemic heart disease (IHD) status post (s/p) coronary artery angiography (CAG) with left ventricular ejection fraction (LVEF) 30% who was on medication. He presented with chest pain and breathlessness nine months prior and his multi-detected computed tomography (MDCT) pulmonary angiography revealed bronchogenic carcinoma. A computed tomography (CT) scan showed a metabolically active lytic lesion involving the left posterior 2^nd rib and degenerative changes were noted in the spine. He has now reported upper back pain for three months localised to the left and right inferior scapular region. His pain scored a nine on the Visual Analogue Scale (VAS), and he was prescribed zoledronic acid 5mg/100ml IV infusion once in 3 weeks. On a revisit, the patient was assessed to be symptomatically better, and the pain score was lowered to 6, indicating reduced severity of discomfort. In conclusion, zoledronic acid is effective in the palliative treatment of lung cancer patients with bone metastasis.