两种剂量硼替佐米联合双膦酸盐治疗多发性骨髓瘤骨病临床对比研究

Clinical Comparative Study of Two Kind Doses of Bortezomib Combinated with Bisphosphonates for Treating Patients with Multiple Myeloma Ostespathy

目的:探讨常规剂量与减低剂量硼替佐米联合双膦酸盐治疗多发性骨髓瘤患者骨病临床疗效及安全性差异。方法:选取本院2011年3月-2015年7月收治多发性骨髓瘤骨病患者150例,以随机区组法分为A、B 2个组,每组病例数各75例,分别采用常规剂量与减低剂量硼替佐米联合双膦酸盐治疗,比较两组患者临床疗效,生活质量改善率、治疗前后NRS评分、IL-6、CRP水平及不良反应发生率等。结果:两组患者临床疗效无显著差异(P>0.05);B组患者生活质量改善率显著高于A组(P<0.05);两组患者治疗后NRS评分、IL-6及CRP水平组间比较差异无统计学意义(P>0.05);两组患者中性粒细胞减少和血小板减少发生率比较差异无统计学意义(P>0.05);B组患者周围神经病变、恶心呕吐、带状疱疹及乏力发生率均显著低于A组(P<0.05)。结论:常规剂量与减低剂量硼替佐米联合双膦酸盐治疗多发性骨髓瘤骨病在缓解疼痛和控制病情进展方面效果接近;低剂量硼替佐米可有效改善患者生活质量和降低不良反应作用的发生风险。

Objective: To investigate the clinical efficacy and safety of conventional dose and reduction dose of bortezomib in combination w ith bisphosphonates for treating patients w ith multiple myeloma ostespathy. Methods: A total of 150 patients w ith multiple myeloma ostespathy w ere chosen in the period from M arch 2011 to July 2015 and randomly w ere divided into 2 groups: A group( 75 cases) and B group( 75 cases). The patients in A and B groups w ere treated w ith conventional dose of bortezomib and reduction dose of bortezomib on the basis of bisphosphonates respectively and the clinical efficacy,the improvement rate of life quality,NRS score,levels of IL-6 and CRP before and after treatment,and the adverse effects of 2 groups w ere compared. Results: There w as no significant difference in the clinical efficacy betw een 2 groups( P < 0. 05). The improvement rate of patients life quality in B group w as significantly better than that in A group( P > 0. 05). There w as no significant difference in the NRS score,levels of IL-6 and CRP after treatment betw een 2 groups( P > 0. 05). There w as no significant difference in the incidence of neutrophil reduction and thrombocytopenia betw een 2 groups( P < 0. 05). The incidence of Bi PN,nausea and vomiting,herpes zoster and fatigue of B group w as significantly low er than that in A group( P < 0. 05). Conclusion: Conventional dose and reduction dose of bortezomib in combination w ith bisphosphonates for treating patients w ith multiple myeloma ostespathy possess the same effects,including pain relief and disease progression control; but the reduction dose of bortezomib application can efficiently improve the life quality of patients and reduce the risk of adverse reactions.