不同分割剂量放疗联合唑来膦酸治疗骨转移癌的分析

目的：探讨两种不同分割剂量放疗联合唑来膦酸治疗骨转移癌的疗效。方法将自2012年2月至2015年7月收治的200例骨转移癌患者随机分为单次分割联合唑来膦酸（单次组）（97例）和常规分割联合唑来膦酸（常规组）（103例）。单次组给予单次剂量8GY放疗＋唑来膦酸（4mg）；常规组给予常规分割30GY＋唑来膦酸（4mg），观察两组治疗效果。结果骨转移癌治疗效果有效率单次组85.57%，常规组71.84%，两组骨转移癌治疗效果的总有效率差异无统计学意义（P〉0.05）。骨痛改善有效率单次组为89.69%，常规组为83.50%，两组骨痛改善有效率差异无统计学意义（P〉0.05）。卡氏（KPS）评分变化有效率单次组为86.60%，常规组为78.64%，两组卡氏（KPS）评分变化有效率差异无统计学意义（P〉0.05）。两组发生不良反应差异无统计学意义（P〉0.05）。结论不同分割剂量放疗联合唑来膦酸治疗骨转移癌疗效明确，单次分割剂量与常规分割剂量的治疗效果相当，但单次分割剂量治疗周期短、次数少、费用低，可推荐为目前治疗骨转移的理想方案。

Objective To explore the therapeutic effects of two fractional doses of radiotherapy combined with zoledronic acid on treating bone metastases.Methods 200 cases of patients with bone metastases that were admitted and treated from February 2012 to July 2015 who were randomly divided into the single fraction radiotherapy combined with zoledronic acid（the single group,n=97）,and the conventional fraction radiotherapy combined with zoledronic acid（the conventional group,n=103）. The single group was administered a single dose radiotherapy（8GY）combined with zoledronic acid（4mg）,while the conventional group was given conventional fraction（30GY）combined with zoledronic acid（4mg）; and the therapeutic effects of the two groups were observed.Results The effective rate of treating the bone metastases in the single group was 85.57%, while that in the conventional group was 71.84%,and the difference in the total effective rate of treating the bone metastases between the two groups was of no statistical significance（P〉0.05）. The effective rates of improving ostealgia in the single group and the conventional group were 89.69% and 83.50%,respectively,with the difference in the effective rate of improve ostealgia between the two groups being of no statistical significance（P〉0.05）. The effective rates of the KPS score changes in the single group and the conventional group were 86.60% and 78.64%,respectively,and the difference in the effective rates of the KPS score changes in the two groups showed no statistical significance（P〉0.05）. The difference in adverse reactions in the two groups showed no statistical significance（P〉0.05）. ConclusionDifferent fractional doses of radiotherapy combined with zoledronic acid had definite therapeutic effects on treating bone metastases,the single fractional dose and the conventional fractional dose had comparable therapeutic effects,but the former was associated with short treatment duration,few frequency and low expense,thus it could be recommended as the ideal scheme for treating bone metastases at present.