Palliative Benefits of Zoledronic Acid on Pain, Functioning and Quality of Life in Metastatic Cancers: A Cohort Study

Objective This cohort study evaluated the palliative benefits of zoledronic acid (ZA) in patients with metastatic cancers, focusing on clinical and functional improvements, with additional assessment of emotional well-being. Methods An observational cohort study was conducted at Omega Hospitals, Guntur, India, from August 2024 to March 2025. Adult patients with metastatic cancers who received at least four doses of intravenous ZA (4 mg) were included. Pain intensity was assessed using the Brief Pain Inventory–Short Form (BPI-SF), and quality of life (QoL) was measured using the EORTC QLQ-C30 questionnaire. Results A total of sixty-two patients (mean age 57.7 ± 9.65 years; 72.6% female) were enrolled. Treatment with ZA resulted in significant reductions in pain severity (median 5.0 to 0.0; p < 0.001) and pain interference (median 3.0 to 0.0; p < 0.001). Improvements were also observed in global health (58.08 to 68.57; p < 0.001), social functioning (57.35 to 64.40; p = 0.01), fatigue (54.81 to 48.88; p = 0.01), and emotional functioning (50.82 to 63.64; p < 0.001). Physical functioning increased slightly (65.44 to 66.50; p = 0.62) but did not reach statistical significance. However, joint pain and hot flashes worsened after treatment ( p < 0.01). Conclusion ZA provides meaningful clinical and functional benefits in metastatic cancer patients, particularly through pain reduction, global health improvement, and better social functioning, with additional gains in emotional well-being. The modest, non-significant change in physical functioning emphasizes the influence of advanced disease stage and comorbidities.