唑来膦酸联合放疗治疗骨转移癌效果观察

Clinical study of zoledronic acid combined with radiotherapy for bone metastases malignancy

目的评价唑来膦酸联合放疗治疗骨转移癌的疗效。方法将80例骨转移癌患者随机、双盲、双模拟分为研究组和对照组，每组40例。研究组应用唑来膦酸4mg静脉滴注，加局部放疗，共2周；对照组行单纯放疗；对治疗前、后的疼痛分级（VRS）、生活质量（QOL）、一般状况评分（KPS）、缓解率和加用止痛剂情况进行比较。同时，对药物的不良事件、血尿常规和生化指标进行评估。结果治疗后两组的VRS及活动能力分级较治疗前明显降低，研究组疼痛总缓解率为97．5％，对照组为72．5％，两组比较差异有统计学意义（P〈0．05）；活动能力改善率为87．5％和65．0％，差异有统计学意义（P〈0．05）；两组QOL、KPS差异有统计学意义（P〈0．01）。对照组有1例在输注唑来膦酸后出现轻度全身疼痛，约8h后自行消失。结论唑来膦酸联合放疗治疗恶性肿瘤骨转移疗效高、安全性好，是目前治疗骨转移癌的优选方案。

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly devided into two groups study group（ n =40 ） ,and the control group （ n =40）. The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy （ DT 30Gy/10f/2w）, control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, biochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively（ P 〈0.05 ） The overall response rate of movement capacity improvement was 87.5 % in the study group and 65.0% in the control group （ P 〈 0.05 ）. There was statistical significance of QOL and KPS in two groups （ P 〈 0.01 ）. An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after g hours. Conclusion Zoledronic acid combined with radiotherapy is effective and safe for treating malignant turnout with mestastatic bone tumours. It is a better way to treat metastatic bone tumors at present.