氯膦酸与唑来膦酸对前列腺癌骨转移镇痛效果的比较

Clodronate versus zoledronic acid in pain control for prostate cancer patients with bone metastases

目的比较氯膦酸及唑来膦酸对晚期前列腺癌骨转移患者治疗的镇痛效果。方法回顾性分析74例因前列腺癌骨转移导致骨痛的晚期前列腺癌患者资料。维持去势水平后分为两组,A组32例,给予口服抗雄药物加固令(氯膦酸)口服,B组42例,予口服抗雄药物外加唑来膦酸(天晴泽泰)注射。两组患者均无肝肾功能不全或病理性骨折。分别在用药前后1、3、6月,采用视觉模拟疼痛评分法(VAS)对两组患者疼痛缓解效果进行评价分析。结果 A组75.0%的患者和B组92.8%的患者能在1月内有效缓解骨痛;治疗6月后,两组患者均能有效降低VAS评分。治疗前后VAS评分:A组5.8/1.9,B组6.1/0.8,差异有统计学意义(P<0.05)。结论唑来膦酸和氯膦酸均能有效缓解前列腺癌骨转移疼痛,但唑来膦酸敏感性高于氯膦酸,且镇痛效果较好。

Objective To compare the analgesic effect for prostate cancer patients with bone metastases between zoledronic acid （ZA） and clodronate （CA）. Methods The clinical data of 74 prostate cancer patients with bone metastases were retrospectively analyzed. All patients received oral androgen blockade after surgical castration, in addition patients in CA group （ n = 32 ） received clodronate and patients in ZA group （ n = 42 ） received zoledronic acid. No patient suffered liver and kidney dysfunction or pathological fractures. Visual analogue scale （VAS） was used to assess pain relief before and 1,3,6 months after treatment. Results Pain was relieved in 75.0% patients in CA group and in 92.8% patients in ZA group 1 month after treatment. VAS scores were significantly improved 6 months after treatment in both groups （5.8 vs 1.9 in CA group;6.1 vs 0.8 in ZA group;both P 〈0.05）. Conclusion Both clodronate and zoledronic acid can relieve bone pain effectively for prostate cancer patients with bone metastases. Zoledronic acid is more effective than clodronate.