晚期恶性肿瘤骨转移患者治疗的临床研究

Clinical study on osteoid metastasis in patients with terminal malignant tumor

目的 观察佳迪 (甲地孕酮 )配合博宁 (帕米膦酸二钠 )改善晚期恶性肿瘤骨转移患者生活质量 (QOL)的疗效。方法 将沈阳军区总医院等 4所医院肿瘤科 2 0 0 2 - 0 3～ 2 0 0 4 - 0 3收治的 16 5例晚期恶性肿瘤骨转移癌患者 ,随机分为佳迪配合博宁组、单药博宁组、15 3Sm EDTMP内照射组。观察骨痛缓解效果、活动能力、Karnofsky评分及毒性反应。 结果 佳迪配合博宁组在缓解骨痛总有效率方面与单药博宁组及 15 3Sm EDTMP内照射组无明显的统计学意义 (P >0 0 5 )。佳迪配合博宁组活动能力改善总有效率方面与单药博宁组及15 3Sm EDTMP内照射组有显著的统计学意义 (P <0 0 5 )。同时 ,佳迪配合博宁组在KPS评分改善方面的总有效率也较单药博宁组及 15 3Sm EDTMP内照射组有非常显著的统计学意义 (P <0 0 1)。结论 佳迪配合博宁能显著提高晚期恶性肿瘤骨转移患者生活质量 ,不良反应轻微 ,值得临床推广。

Objective To observe the curative effect of Jiadi (megestrol acetate) combined with Bonin (Pamidronate Disodium for injection) for improvement of the quality of life (QOL) in patients with terminal osteoid metastasis.Methods During March 2002 to March 2004,totally 165 inpatients with terminal osteoid metastasis were recruited from the department of tumor of four hospitals,such as General Hospital of Shenyang Command.Then the subjects were randomized into combination treatment group (Jiadi+Bonin),Bonin treatment group,and internal irradiation group with 153Sm-EDTMP.Effects on the relief of bone pain,motor function,scores of Karnofsky performance scale (KPS) and toxic reaction were observed in the three groups.Results There were no significant changes in the total remission rate of pain in the combination group compared with the Bonin group or internal irradiation group (P>0.05).Improvement in the total effective rate of motor function was significant in the combination group compared with Bonin group or internal irradiation group (P<0.05),and simultaneously the difference in the scores ofKPS was very significant between the combination group and the latter two groups (P<0.01).Conclusion Jiadi combined with Bonin plays a remarkable role in improving the QOL of patient with terminal osteoid metastasis with few adverse effects,which is good for clinical application.