التحضير للعلاج قبل الشروع في العلاج بالعوامل الموجهة للعظام لحالات النقائل العظمية

References

DOI: 10.1016/j.annonc.2020.07.019

• Vitamin D levels are typically low in cancer patients and those with vitamin D deficiency should have their levels corrected with oral vitamin D3 (25‑50 000 IU per week for 4‑8 weeks).
• Vitamin D levels should be maintained with daily supplements (800‑2000 IU per day) of vitamin D3.
• Calcium supplementation may also be required to ensure an adequate daily intake of 1000‑1200 mg per day.
• If a calcium-enriched diet is not sufficient to ensure the uptake of 1000‑1200 mg calcium per day, a supplementation of 500‑1000 mg is recommended.
• Before BTA therapy is initiated, an oral examination and appropriate preventive dentistry are strongly recommended.
• Patients should avoid invasive dental procedures (extractions and implants) during therapy if possible, maintain good oral hygiene and ensure regular dental/oral surgery review.
• Calcium levels should be monitored, especially during the first few months of treatment and vitamin D levels assessed before starting treatment.
• Correction of vitamin D deficiency and vitamin D supplementation with adequate intake of calcium throughout treatment to maintain normal serum calcium are recommended.