唑来膦酸与放疗联合治疗对恶性肿瘤骨转移的效果观察

Observation on the effect d zoledronic acid combined with radiotherapy in the treatment for malignaut tumor withbone metastases

目的观察唑来膦酸与放疗联合对恶性肿瘤骨转移的治疗效果。方法选取我院患者从2010年2月至2012年1月所收治的恶性肿瘤骨转移患者55例作为临床研究对象，将所有患者随机分为治疗组和对照组两组，所有患者均使用西门子直线加速器6MV对骨转移的疼痛处进行姑息性放疗，治疗组在对照组的基础上加用唑来膦酸进行治疗。观察两组患者的镇痛效果、止痛起效时间和不良反应，以及治疗组治疗前后的血钙、血磷和血镁值。结果治疗组总有效率为96．4％，平均起效时间为（3．2±1．1）d；对照组总有效率为78．2％，止痛起效时间为（7_3±1．9）d。差异有显著性（P〈0．05）。治疗组患者主要出现发热、胃肠道不适、低血钙、蛋白尿和血清肌酐轻度升高。对照组患者则未发现明显不良反应。治疗组用药前后的血钙、血磷和血镁值差异无显著性（P〉0．05）。结论放疗联合唑来膦酸可以有效控制疼痛，同时保护并修复被破坏的骨质功能，改善患者生活质量，因此我们推荐这种联合治疗方式在临床当中使用。

Objective To explore the effect of zoledronic acid combined with radiotherapy in the treatmentfor malignant tumor with bone metastases. Methods 55 cases of patients with malignant tumor with bone metas- tases accessed in our hospital from February 2010 to January 2012 were selected as objects and they were ran- domly divided into two groups, Siemens linear accelerator 6MV was applied to the treatment of the pain of bone metastases to all of them. Zoledronic acid supplemented to radiotherapy was given to treatment group. The anal- gesic effect, the time of producing analgesic effect and adverse reaction, the blood phosphorus, the blood calcium and the blood magnesium were recorded. Reeuhs The validity rate in treatment group was 96.4%, the average time of producing analgesic was （3.2 ± 1.1） days. The validity rate in control group was 78.2%, the average time of producing time was （7.3 ± 1.9） days. The difference was statistically significant （P〈0.05）. The adverse reaction in the treatment group was fever, gastrointestinal intolerance, low blood calcium, proteinuria and a moderately ele- vated serum creatinine. No adverse reaction was found in the control group. The difference of blood phosphorus, blood calcium and blood magnesium in treatment group was not statistically significant （P〉0.05）. Conclusions Radiotherapy combined with zoledronic acid is an effective method of controlling pain, it can protect and recover the function of bone, improve the quality of life. So we recommend this combine method to be used in clinic.