非小细胞肺癌骨转移发生骨相关事件的风险因素分析

Risk Factors for Skeletal-Related Events in Non-Small Cell Lung Cancer Patients with Bone Metastases

目的:探讨非小细胞肺癌骨转移患者发生骨相关事件(SREs)的风险因素。方法:回顾分析2009年1月—2010年12月复旦大学附属中山医院314例非小细胞肺癌骨转移患者的临床资料。结果:129例(41.1%)患者发生SRE,其中15例发生1次以上SREs。有软组织肿块(P≤0.001)和无双磷酸盐治疗(P=0.009)是发生SREs的风险因素。无靶向治疗(P=0.042)、有软组织肿块(P=0.004)和血白蛋白低(P=0.006)的患者发生首次SREs的中位时间较短。结论:有软组织肿块和无双磷酸盐治疗是发生SREs的风险因素,因此应密切观察和积极治疗有软组织肿块的骨转移患者,而所有骨转移患者应尽早用双磷酸盐治疗。

Objective：To identify the risk factors for skeletal-related events（SREs） in non-small cell lung cancer（NSCLC）patients with bone metastases.Methods： The clinical data of 314 NSCLC patients with bone metastases at Zhongshan Hospital,Fudan University between January 1999 and December 2006 were retrospectively analyzed.Results： Among 314 NSCLC patients with bone metastases,129 patients（41.1%） had at least one SREs and 15 of those experienced multiple SREs.soft-tissue mass（P≤0.001） and no history of bisphosphonate therapy（P=0.009） are more likely to have SREs.Soft-tissue mass（P=0.004）,serum albumin decrease（P=0.006） and no history of target therapy（P=0.042） were independent risk factor of shorter median time to first SREs.Conclusions： Patients with characteristics such as soft-tissue mass and no history of bisphosphonate therapy are more likely to have SREs,so more attention should be paid to these patients and bisphosphonate treatment should be delivered to them as early as possible.Soft-tissue mass,serum albumin decrease and no history of target therapy were independent risk factor of shorter median time to first SREs.