唑来膦酸联合PCMF方案治疗乳腺癌多发性骨转移的临床观察

Clinical Observation of Zoledronic Acid Combined with PCMF Plan for Varied Metastatic Bone of Breast Cancer

目的观察比较唑来膦酸联合PCMF方案治疗乳腺癌多发性骨转移的临床疗效。方法将48例骨转移癌患者随机分成2组:单纯化疗组:按PCMF方案标准用药;联合治疗组:唑来膦酸联合PCMF方案治疗。结果止痛效果评价,单纯化疗组有效率54.1%(13/24),联合化疗组有效率87.5%(23/24),后者显著高于前者(P<0.05);骨转移灶疗效评价,单纯化疗组有效率37.5%(9/24),联合化疗组有效率62.5%(15/24),后者优于前者(P<0.05)。治疗观察期间至少发生1次骨相关事件的患者比例分别为单纯化疗组的58.3%(19/24),联合化疗组37.5%(9/24),后者明显低于前者(P<0.05)。一般状况评价,单纯化疗组、联合化疗组的Karnofsky评分平均值分别增加11.9分和21.9分。不良反应主要为流感样症状、骨痛、发热、恶心。结论唑来膦酸联合PCMF方案治疗乳腺癌多发性骨转移疗效确切,作用时间长、不良反应轻,是临床上治疗乳腺癌多发性骨转移、控制骨痛、减少骨相关事件、提高患者生存质量的理想配伍疗法。

Objective To observe and compare the curative effect of Zoledronic acid combined with PCMF plan for varied metastatic bone of breast cancer. Methods 48 patients with metastatic bone of breast cancer were randomized into two groups：24 patients in chemotherapy group received PCMF plan, and 24 patients in combination group were treated with both Zoledronic acid combined with PCMF plan. The effects were evaluated when four cycles finished. Results The overall response rate of pain relief in chemotherepy group and combination group was 54.1%（13/24） and 87.5%（23/24） respectively（P〈0.05）. The overall respons rate of bone metastasis in chemotherapy group and combination group was 37.5%（9/24） and 62.5%（15/24） respectively（P〈0,05）. The proportion of patients with at least one SREs during of treating and observing was higher in chemotherapy group 58.3% （19/24） than that in combination group 37.5% （9/24）（P〈0.05）. The average Karnofsky performance status was increased by 11.9 and 21.9 respectively. The common side-effects were syndyome of flu, pain of bone, fever and nausea. Conclusion Zoledronic acid combined with PCMF plan for varied metastatic bone of breast cancer is accuracy of effect, longer time,mild of side-effects,and it is the ideal scheme to treat metastatic bone of breast cancer,to control pain of bone,decrease SREs,and enhance living quality of patients.