唑来膦酸联合厄罗替尼治疗非小细胞肺癌骨转移临床疗效观察

Zoledronic acid combined with erlotinib in the treatment of advanced non-small cell lung cancer with bone metastasis and review of literature

目的观察唑来膦酸联合厄罗替尼治疗晚期非小细胞肺癌(NSCLC)骨转移的疗效及安全性,并进行相关文献复习。方法将60例NSCLC晚期骨转移患者随机分为两组,唑来膦酸组30例,对照组30例。唑来膦酸组接受唑来膦酸联合厄罗替尼方案治疗,对照组为单纯厄罗替尼分子靶向治疗。结果唑来膦酸组(唑来膦酸+厄罗替尼):有效率(CR+PR)为16.7%,疾病控制率(CR+PR+SD)为63.3%;总体平均生存期达到11.6个月(2～22个月),中位生存期为9个月,1年生存率为19.3%。对照组(单用厄罗替尼):有效率为10.0%,疾病控制率为53.3%;总体平均生存期达到8.5个月(2～22个月),中位生存期为7个月,1年生存率为16.7%。骨病灶控制唑来膦酸组的有效率为40.0%,疾病控制率为83.3%,而对照组有效率为13.3%,疾病控制率为36.7%,差异有统计学意义(P<0.05)。骨转移疼痛缓解率唑来膦酸组为79.2%,对照组为40.0%,差异有统计学意义(P<0.05)。结论唑来膦酸联合厄罗替尼分子靶向治疗对NSCLC骨转移患者不仅有较好的止痛作用,还可以改善症状,延长生存时间,提高生活质量。

Objective To observe the efficacy of zoledronic acid combined with erlotinib in treatment of non-small cell lung cancer（NSCLC） with bone metastasis and review of literature.Methods 60 cases of NSCLC patients with bone metastases were randomly divided into two groups,namely the zoledronic acid group of 30 patients and control group 30 cases.Zoledronic acid group received zoledronic acid combined with erlotinib molecular tageted therapy,and the control group was received simply erlotinib molecular tageted therapy.Results The control of lung lesions：Zoledronic acid group：（CR＋PR）16.7%,（CR＋PR＋SD）63.3%;control group：（CR＋PR）10.0%,（CR＋PR＋SD）53.3%;The overall average survival period was 11.6 months（3 ~ 22 months） in Zoledronic acid group and 8.5 months（2 ~ 22 months） in the control group,with a median survival time zoledronic acid group of 9 months and 7 months in the control group.Control of bone lesions：Zoledronic acid group：（CR＋PR）40.0%,（CR＋PR＋SD）83.3%;control group：（CR＋PR）13.3%,（CR＋PR＋SD）36.7%（P0.05）.The rate of bone metastasis pain relief in zoledronic acid group was 79.2%,control group 40.0%（P0.05）.Conclusion Zoledronic acid combined with erlotinib is very effective to treat NSCLC with bone metastasis,not only has good analgesic effect and increase survival rate,but also improve the quality of life.Although the toxic effects for lung cancer cells,the precise mechanism and the optimal concentration and interval with the combination of zoledronic acid and erlotinib still need to further study.But for advanced lung cancer patients with bone metastasis may be a better clinical option.