唑来膦酸联合放疗治疗骨转移癌的临床疗效分析

Zoledronic acid in combination with radiotherapy in treatment of bone metastases

目的探讨唑来膦酸联合放疗治疗骨转移癌的临床疗效。方法将120例骨转移癌患者随机分成A、B、C三组,A组为单纯放疗组(40例)、B组为单纯唑来膦酸组(40例)、C组为联合治疗组(40例)。C组采用唑来膦酸4 mg静脉滴注联合局部放疗30 Gy/10 f/2 w,A组、B组使用方法和剂量与C组相同。通过治疗前、后的疼痛分级、一般状况评分(KPS)变化、骨质修复率,进行治疗效果的比较。结果治疗后三组的疼痛分级均有下降,一般状况(KPS)较治疗前有明显提高。C组疼痛缓解率为97.5%(39/40),A组为75.0%(30/40),B组为72.5%(29/40),差异具有统计学意义(P<0.05)。C组生活质量改善率为92.5%,A组为75.0%,B组为70.0%,差异具有统计学意义(P<0.05)。骨质修复率C组为60.0%,A组为35.0%,B组为37.5%,差异具有统计学意义(P<0.05)。结论唑来膦酸联合放疗治疗骨转移癌,镇痛效果好,疼痛缓解明显,患者的生活质量也有明显提高,是目前治疗骨转移癌的理想方案。

Objective To evaluate the clinical effects of zoledronic acid in combination with radiotherapy in the treatment of bone metastases. Methods One-hundred-twenty patients with bone metastases were enrolled in this study. Patients were randomly assigned to three groups： 40 cases were treated with radiotherapy at a plan of 30 Gy/10 f/2 w （group A）,40 cases were treated with 4 mg zoledronic acid intravenously （group B） and 40 cases were treated with zolendronic acid in combination with radiotherapy （group C）. Pain was evaluated with verbal rating scale （VRS）, general performance was evaluated with KPS scores and bone reparation rate was documented before and after treatment in 3 groups. Results All groups were benefited after treatment in VRS and KPS scores. The response rates of group A, B and C were 75.0% （30/40） ,72.5% （29/40） ,97.5% （39/40） ,respectively （P 〈0. 05）. The improvement rates of quality of life were 75.0% ,70.0% and 92.5% ,respectively （P 〈 0.05 ）. The bone reparation rates were 35.0% ,37.5% and 60.0%, respectively （ P 〈 O. 05 ）. Conclusion Zoledronic acid in combination with radiotherapy showed promising results, and this therapeutic regimen may be a better choice in the treatment of bone metastases.