肺癌骨转移临床资料分析及治疗研究

Analysis of the clinical material of lung cancer bone shifts and the research of the treatment

目的分析63例肺癌骨转移患者的临床资料,探讨肺癌骨转移的治疗原则。方法回顾性分析2004年1月至2008年1月收治的63例肺癌骨转移患者的临床资料。全部病例均经细胞学和(或)组织病理学证实为原发性支气管肺癌患者,根据患者的骨痛症状,以及ECT、X线、CT、MRI检查中的任2项检查发现有明显骨质破坏表现而最终证实为骨转移。按治疗方法不同分为两组,A组:同期放、化疗加帕米膦酸二钠;B组:序贯放、化疗加帕米膦酸二钠。A组30例,B组33例。所有患者均临床随访1年以上。结果本组病例中腺癌为主(占65.1%),63例中有27例为单发骨转移,占42.9%,多发骨转移36例,占57.1%。骨转移部位:单发骨转移中以肋骨转移最多见,共有11例,占17.5%。A组治疗后疼痛缓解率(CR+PR)为86.7%;B组为39.4%;A、B组差异有统计学意义(χ2=5.416 7,P=0.02);A组治疗后局部病灶的总有效率(CR+PR)为60.0%;B组为33.3%;A、B组差异有统计学意义(χ2=4.498 2,P=0.034)。结论肺癌骨转移中腺癌发生率相对较高,以多发骨转移多见。采取同期放、化疗为主的综合治疗可明显减轻症状。

Objective To analyse shifts patientrs clinical material and the treatment research to 63 example lung cancer bone. Methods 63 consecutive cases were analyzed with bone scanning and compared with other radioiogical examinations （MRI,CT and X-ray）. All cases were confirmed by cytology and / or histological. They were randomly divided into two groups： Group A ：30 cases（the same period of radiotherapy and chemotherapy plus pamidronate;） and group B： 33 cases （Sequential radiotherapy and chemotherapy ＋pamidronate）. All patients were followed up more than 1 year. Results The most cases were adenoearcinoma （65.1%）. 27 cases of 63 cases were single bone metastasis（42.9%）. 36 cases were multiple bone metastasis（57. 1%）. The rib bone was the most frequent metastatic sites（17.5%）. The pain relief rate （CR＋PR） was 86.7% in gro＇up A,39.4% in group B. There was significant difference between group A and group B（χ^2=5. 416 7,P= 0.02）. The total effective rate of partial lesion （CR＋PR） was 60.0% in group A,and 33.3% in group B. There was significant difference between group A and group B（χ^2= 4. 498 2,P =0. 034）. Conclusion Adenoearcinoma has the highest rate of osseous matastasis,By sends the bone to shift sees. The comprehensive treatment based on radiotherapy and chemotherapy can significantly reduce the symptoms.