唑来膦酸联合化学治疗方案治疗老年肺癌骨转移的疗效分析

Effect of Zoledronic acid combined with chemotherapy on bone metastases of senile lung cancer

目的研究唑来膦酸联合化学治疗方案对老年肺癌骨转移患者的临床治疗效果。方法将遵义市第一人民医院2012年1月至2014年6月收治的80例老年肺癌骨转移患者随机分为对照组和联合组,每组40例,对照组采用常规化学治疗方案治疗,联合组采取唑来膦酸联合化学治疗方案治疗,观察患者治疗前后活动受限改善情况、骨痛镇痛效果、骨不良事件和不良反应,并检测Ca2+浓度、碱性磷酸酶(AKP)水平和血清炎性细胞因子肿瘤坏死因子α(TNF-α)、IL-1β水平的变化。结果联合治疗组患者活动受限改善有效率及疼痛缓解情况较对照组患者显著提高(P<0.05);联合治疗组患者经治疗后可呈时间依赖性地降低血清Ca2+、AKP及TNF-α、IL-1β水平,且与对照组患者治疗后同时间点比较显著降低;联合组患者治疗后骨不良事件和不良反应发生率明显低于对照组。结论唑来膦酸联合化学治疗应用于老年肺癌骨转移患者的治疗,可增强化学治疗疗效,有效缓解患者活动受限情况和疼痛症状,并降低骨不良事件和不良反应发生率,改善患者生活质量,上述作用可能与降低血钙及炎症因子释放有关。

Objective To investigate clinical therapeutic effect of zoledronic acid combined with chemotherapy to senile lung cancer with bone metastases. Methods Totaily 80 cases of senile lung cancer patients with bone metastasis were randomly divided into control group and combined group, 40 cases in each group. Limitation of activity to the situation, release of bone pain, adverse events and side effects were observed. Serum Ca2＋ concentration,alkaline phosphatase （AKP） levels and the levels of serum inflammatory cytokines TNF-α,IL-1β were detected. Results Limitation of activities and pain of patients with combined treatment was significantly ameliorated compared to control group （P〈0.05）. Serum Ca^2＋ , AKP and TNF-α, IL-1β levels were significantly decreased in patients with combined group in time-dependent manner,and which were significantly lower than control group. Bone adverse events and side effects in patients with combined treatment were significantly lower than in patients with control group. Conclusion Zoledronic acid combined with chemotherapy can enhance the efficacy of chemotherapy,effectively relieve the limitation of activities and pain symptoms and reduce the incidence of bone adverse events and adverse reactions. The effect may be related to the decrease of serum calcium and the inflammatory cytokines.