唑来膦酸联合氯化锶治疗癌症骨转移患者临床疗效

Clinical efficacy of zoledronic acid combined with strontium chloride in the treatment of bone metastasis of cancer

目的探讨唑来膦酸联合氯化锶(89SrCl2)治疗癌症骨转移患者的临床疗效。方法选取自2017年3月至2019年3月北部战区总医院收治的50例癌症骨转移患者为研究对象。根据治疗方法将患者分为89SrCl2治疗组(n=24)和89SrCl2联合唑来膦酸组(n=26)。观察两组患者治疗前后疼痛数字(NRS)评分等级、血液学指标变化、治疗后止痛疗效以及不良反应发生情况。结果治疗1个月、3个月,两组患者NRS评分等级比较,差异有统计学意义(P<0.05),89SrCl2治疗组完全有效患者占41.7%(10/24),低于89SrCl2联合唑来膦酸组的73.1%(19/26),差异有统计学意义(P<0.05)。治疗3个月,89SrCl2联合唑来膦酸组乳腺癌痛疗效优于89SrCl2治疗组,差异有统计学意义(P<0.05)。89SrCl2联合唑来膦酸组起效时间早于89SrCl2治疗组,疼痛缓解持续时间、完全无痛时间长于89SrCl2治疗组,差异有统计学意义(P<0.05)。治疗3个月后,两组患者血清碱性磷酸酶水平均显著低于治疗前,差异有统计学意义(P<0.05)。两组患者均未出现呕吐、发热、腹泻、过敏等不良反应。结论单独使用89SrCl2以及89SrCl2联合唑来膦酸治疗癌症骨转移均有较好疗效且安全性佳,但联合治疗起效更快、作用时间更长、止痛疗效更优。

Objective To investigate the clinical efficacy of zoledronic acid combined with strontium chloride(89SrCl2)in the treatment of bone metastasis of cancer.Methods A retrospective study was performed on 50 cases of patients with bone metastasis who were admitted from March 2017 to March 2019.According to the treatment method,the patients were divided into the 89SrCl2 treatment group(n=24)and the 89SrCl2 combined zoledronic acid group(n=26).The numeric rating scales(NRS)score,hematological index,analgesic effect and adverse reactions were observed before and after treatment in the two groups.Results Comparison of NRS scores between the two groups at 1 month and 3 months after treatment showed a statistically significant difference(P<0.05).The fully effective rate of the 89SrCl2 group was 41.7%(10/24),which was lower than that of the 89SrCl2 combined zoledronic acid group(73.1%,19/26),P<0.05.The effect of 89SrCl2 combined with zoledronic acid on breast cancer pain after 3 months of treatment was better than that of the 89SrCl2 group(P<0.05).The onset time of the 89SrCl2 combined with zoledronic acid group was earlier than that of the 89SrCl2 treatment group,and the duration of pain relief and complete pain-free time were longer than that of the 89SrCl2 treatment group(P<0.05).After 3 months of treatment,alkline phosphatase level in both groups was significantly lower than that before treatment(P<0.05).No adverse reactions such as vomiting,fever,diarrhea or allergy occurred in both groups.Conclusion 89SrCl2 alone or 89SrCl2 combined with zoledronic acid are both effective and safe,but combined therapy has faster onset,longer duration and better analgesic effect.