唑来膦酸联合放疗治疗恶性肿瘤骨转移的疗效观察

Curative effect of zoledronic acid combined with radiotherapy for osseous metastasis

目的:观察唑来膦酸联合放疗对恶性肿瘤骨转移疼痛、生活质量及肿瘤的疗效。方法:将61例有骨转移的恶性肿瘤患者分为二组,治疗组(31例)给予唑来膦酸4mg,4周重复一次,共4-6周。第二天开始放疗,采用直线加速器6MV-X射线和(或)9-15MEV电子线照射。放疗剂量:常规分割2.0Gy/次,5次/周,DT40-50 Gy;大分割照射3-5 Gy,3-5次/周,DT20-30Gy。对照组(30例)仅行唑来磷酸治疗,方法及剂量同上。结果:治疗组与对照组止痛效果总有效率(CR+PR)分别为96.7%和76.7%(P<0.05),活动能力的改善治疗组与对照组总有效率(显效+有效)分别为80.6%和56.7%(P<0.05),不良反应主要表现为白细胞下降、恶心、发热和肌痛,多为Ⅰ、Ⅱ级。结论:唑来磷酸与放疗联用对于恶性肿瘤骨转移有明确的止痛作用,能改善患者生活质量,不增加不良反应。

Objective：To observe the effect of zoledronic acid combined with radiotherapy for cancer osseous metastasis.Methods： We divided 61 osseous metastasis cancer patients into two groups.For treated group（31 cases）,we gave them zoledronic acid 4mg,once every four weeks,total 4-6 cycles.And at the second day we started to apply radiotherapy with linear accelerator 6MV-X rays and/or 9-15MEV electron line.Radiotherapy dose： conventional division 2.0Gy/time,5 times/week,DT40-50 Gy;high dose radiotherapy 3-5 Gy,3-5 times/week,DT20-30 Gy.For control group（30 cases）,we only used zoledronic acid with the same method and same doses.Results：For the effect of pain-relief,the total effective rate（CR＋PR） of treated group and control group was respectively 96.7% and 76.7%（P0.05）.And for the effect of action capacity,the total effective rate（CR＋PR）of treated group and control group was respectively 80.6% and 56.7%（P0.05）.Most of side effect was Ⅰ,Ⅱ grades such as leucocyte decline,nausea,fever and myalgia.Conclusion：It had obvious analgesic effect to use zoledronic acid combined with radiotherapy for cancer osseous metastasis,and it could improve patients＇ quality of life and would not increase toxic reaction.