不同分割剂量放疗联合唑来膦酸治疗骨转移癌的临床研究

Clinical Study on Different Fraction Radiotherapy Combined with Zoledronic Acid in the Treatment of Cancer Patients with Bone Metastasis

目的探讨不同分割剂量放疗联合唑来膦酸治疗骨转移癌的疗效。方法将110例骨转移癌患者随机分为3组。3组均静脉点滴唑来膦酸4mg。A组40例采用低分割照射,DT30Gy/10次/3周;B组37例采用常规分割,DT40Gy/20次/4周;C组33例不照射。结果(1)治疗结束时疼痛缓解总有效率为A组90.0%,B组86.5%,C组66.7%(A组与C组χ2=6.03,P<0.05,B组与C组χ2=3.80,P<0.05;A组与B组χ2=0.02,P>0.05);(2)KPS评分变化为A组82.5%,B组70.3%,C组51.5%(A组与C组χ2=8.04,P<0.05;B组与C组χ2=4.43,P<0.05;A组与B组χ2=0.54,P>0.05);(3)骨转移灶修复情况A组84.3%,B组76.9%,C组57.7%(A组与C组χ2=10.69,P<0.05;B组与C组χ2=4.94,P<0.05;A组与B组χ2=1.17,P>0.05)。结论唑来膦酸联合放疗治疗骨转移癌疗效优于单纯唑来膦酸,但是低分割照射治疗周期短、费用低。

Objective To evaluate the efficacy of different fraction radiotherapy combined with zoledronic acid for bone metastatic cancer. Methods 110 cases with bone metastatic cancer were randomized into 3 groups. All patients were treated with zoledronic acid,4 mg intravenously. The group A （40 cases） had received hypofraction： DT 30 Gy ten times for three weeks; the group B （37 cases） received conventional fraction：DT 40 Gy, twenty times for four weeks the group C （33 cases） no radiotherapy. Results （1）The total effective rate of easement of pain was group A（90.0%）, group B（86.5%）, group C（66.7%）,respectively（group A with group C X^26.03, P〈0.05;Group B with group C X^2=3.80,P〈0.05;group A with group B X^2=0.02, P〉0.05）. （2）The score of KPS to heighten was group A 82.5%,group B 70.3%,group C 51.5%,respectively. （group A with group C X^2=8.04,P〈0.05;group B with group C X^2=4.43, P〈0.05; group A with Group B X^2=0.54,P〉0.05）. （3）The osseous metastasis to be repaired was group A 84.3%, group B 76.9%, group C 57.7%, respectively（group A with group C X^2=10.69,P〈0.05;Group B with group C X^2=4.94,P〈0.05; Group A with group B X^2=1.17,P 〉 0.05）. Conclusion Zoledronic acid combined with radiotherapy is superior to zoledronic acid alone for bone metastatic cancer. Hypofraction radiotherapy may decurtate treatment cycle degrade treatment expense.