唑来膦酸为主治疗乳腺癌骨转移骨痛40例疗效观察

The curative effect of diphosphate on bony metastasis and ostalgia from 40 cases of breast cancer

目的探讨以唑来膦酸为主治疗乳腺癌骨转移骨痛的临床疗效。方法选择新疆医科大学附属肿瘤医院2005年6月—2010年6月晚期有骨转移的乳腺癌患者40例,其中单纯使用唑来膦酸治疗20例(单纯组),联合放化治疗20例(联合放化组)。用唑来膦酸4mg溶于生理盐100mL中,静脉滴注15min以上,每4周1次,共2～4个周期,同时对有化疗及放疗指征者用唑来膦酸治疗第3d后开始化、放疗,以完全缓解(CR)、部分缓解(PR)、轻度缓解(MR)及无效(NR)来评估疗效。结果全组40例,CR9例,PR21例,MR7例,NR3例,总有效率为75%,其中单纯使用唑来膦酸20例,CR4例,PR10例,有效率为70%,唑来膦酸联合使用化、放疗20例,CR5例,PR11例,有效率为80%。全组病例不良反应主要为发热(20例),8例出现肌肉酸痛和骨痛加重现象。结论第3代双膦酸盐唑来膦酸对晚期骨转移痛所致骨痛疗效确切,使用安全,合并使用化、放疗的病例中,止痛疗效较好。

Objective To investigate the curative effect of diphosphate on bony metastasis and ostalgia of breast cancer.Methods From june 2005 to june 2010,40 cases of breast cancer from the affiliated tumor hospital of Xinjiang medical university that have bony metastasis and ostalgia with the treament of diphosphate were analyzed retrospectively.We evaluate the curative effect with CR,PR,SR and invalid after diphosphate treatment that put 4 mg into 100 mL 0.9% NaCl,intravenously guttae more than 15 mins every four weeks about 2~4 cycles even by radiotherapy or chemotherapy after three days with diphosphate treatment.Results Of the 40 patients,the cases of CR,PR,MR,NR were 9,21,7 and 3 retrospectively,and the total effective rate was 75%.Of the 20 cases which only used diphosphate,the cases of CR and PR were 4 and 10 retrospectively,of the 20 cases which used diphosphate and radiotherapy or chemotherapy,the cases of CR and PR were 5 and 11,and the total effective rate was 80%.And in the most of adverse reactions,20 cases were fever,8 cases were muscle pain and aggravated bone pain.Conclusion The curative effect of third generation diphosphate is obviously safe for ostalgia from augmentation and even more than single-use diphosphate compare with combining radiotherapy or chemotherapy.