静脉补液和药物治疗可以使恶性肿瘤相关性高钙血症暂时恢复正常。 根除潜在恶性肿瘤是永久性逆转高钙血症的关键。
恶性肿瘤体液性高钙血症或局部溶骨性高钙血症
静脉补液和降钙素可在治疗开始的24到48个小时内改善高钙血症。[1]Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.http://www.ncbi.nlm.nih.gov/pubmed/15673803?tool=bestpractice.com[9]Ljunghall S. Use of clodronate and calcitonin in hypercalcemia due to malignancy. Recent Results Cancer Res. 1989;116:40-5.http://www.ncbi.nlm.nih.gov/pubmed/2527399?tool=bestpractice.com[10]Chevallier B, Peyron R, Basuyau JP, et al. Human calcitonin in neoplastic hypercalcemia. Results of a prospective randomized trial [in French]. Presse Med. 1988 Dec 17;17(45):2375-7.http://www.ncbi.nlm.nih.gov/pubmed/2974978?tool=bestpractice.com 静脉给予双膦酸盐是最有效,可以在 10 天内使多数患者血钙恢复正常。[1]Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.http://www.ncbi.nlm.nih.gov/pubmed/15673803?tool=bestpractice.com[7]Major P, Lortholary A, Hon J, et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol. 2001 Jan 15;19(2):558-67.http://www.ncbi.nlm.nih.gov/pubmed/11208851?tool=bestpractice.com 效果的持续时间是不同的。[7]Major P, Lortholary A, Hon J, et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol. 2001 Jan 15;19(2):558-67.http://www.ncbi.nlm.nih.gov/pubmed/11208851?tool=bestpractice.com 高钙血症的持续缓解需要有效的抗肿瘤治疗。
骨化三醇(1,25-二羟维生素D)介导的高钙血症
静脉补液和降钙素可在治疗开始的24到48个小时内暂时改善高钙血症。[1]Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.http://www.ncbi.nlm.nih.gov/pubmed/15673803?tool=bestpractice.com[9]Ljunghall S. Use of clodronate and calcitonin in hypercalcemia due to malignancy. Recent Results Cancer Res. 1989;116:40-5.http://www.ncbi.nlm.nih.gov/pubmed/2527399?tool=bestpractice.com[10]Chevallier B, Peyron R, Basuyau JP, et al. Human calcitonin in neoplastic hypercalcemia. Results of a prospective randomized trial [in French]. Presse Med. 1988 Dec 17;17(45):2375-7.http://www.ncbi.nlm.nih.gov/pubmed/2974978?tool=bestpractice.com 需要使用几天糖皮质激素治疗才能改善血清钙水平。[16]Binstock ML, Mundy GR. Effect of calcitonin and glutocorticoids in combination on the hypercalcemia of malignancy. Ann Intern Med. 1980 Aug;93(2):269-72.http://www.ncbi.nlm.nih.gov/pubmed/7406378?tool=bestpractice.com 效果的持续时间并没有被广泛研究。