恶性肿瘤溶骨性骨转移疼痛的临床特征与疗效的相关性分析

The relationship of clinical features and treatment prognosis for patients with cancer osteolytic bone metastasis pain

目的探讨恶性肿瘤溶骨性骨转移疼痛的临床特征与疗效的相关性。方法选取2010年9月至2013年3月收治的150例恶性肿瘤溶骨性骨转移疼痛患者,给予唑来膦酸和帕米膦酸二钠治疗,观察患者的一般资料、疗效和实验室指标。结果疼痛控制显效患者为98例,有效患者为32例,无效患者为20例,总有效率为86.7%。治疗后2周和治疗后4周的视觉模拟评分法(VAS)评分明显低于治疗前水平,差异有统计学意义(P<0.05)。单因素统计分析结果显示,临床分期、碱性磷酸酶水平、分化程度和年龄与疗效显著相关,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,临床分期、分化程度和年龄是影响患者疗效的主要危险因素。结论恶性肿瘤溶骨性骨转移疼痛可显著影响患者的预后,药物综合治疗能有效控制疼痛。肿瘤的临床分期、分化程度和年龄是影响疗效的主要危险因素。

Objective To investigate the relationship of clinical features and treatment prognosis for cancer osteolytic bone metastasis pain. Methods A total of 150 cases with cancer osteolytic bone me- tastasis pain were selected in our hospital from September 2010 to March 2013. All cases were treated with zoledronic acid and pamidronate. The patient＇s general information, prognosis and laboratory parameters were observed and investigated. Results The cases for markedly effective pain control, effective pain con- trol and ineffective pain control were 98, 32 and 20, respectively. The total effective rate was 86. 7%. The VAS scores of post-therapy 2 weeks and post-therapy 4 weeks were significantly lower than that of pre-thera- py （ P 〈 0. 05 ）. The results of univariate analysis showed that the clinical stage, alkaline phosphatase, dif- ferentiation and age were significantly correlated with the prognosis of patients （ P 〈 0. 05 ）. The results of multivariate Logistic regression analysis showed that the clinical stage, differentiation and age were the main prognostic risk factors. Conclusion Cancer osteolytic bone metastasis pain can significantly influence prog- nosis, combined drug therapy can effectively control pain. The clinical stage, differentiation and age are the main risk factors for prognosis.