盐酸羟考酮缓释片联合注射用唑来膦酸对晚期乳腺癌骨转移同期放化疗患者癌痛和生活质量的影响

Effect of oxycodone hydrochloride sustained-release tablets combined with zoledronic acid for injection on cancer pain and quality of life of advanced breast cancer bone metastasis patients treated with concurrent chemoradiotherapy

目的探究盐酸羟考酮缓释片联合注射用唑来膦酸对晚期乳腺癌骨转移(BCBM)同期放化疗患者癌痛和生活质量的影响。方法选择2017年1月至2019年3月安阳市肿瘤医院的晚期BCBM同期放化疗患者62例,按照随机数字表法分为对照组与观察组,每组31例。对照组使用注射用唑来膦酸对晚期BCBM同期放化疗患者进行治疗,观察组在对照组治疗基础上加用盐酸羟考酮缓释片,疗程为12周。比较2组患者治疗前及治疗12周后疼痛程度[疼痛数字评分量表(NRS)评分]、身体功能状态(KPS评分)和生活质量[乳腺癌患者生命质量测定量表(QLQ-BR53)评分],观察并记录2组患者用药后药物不良反应发生情况。结果治疗12周后,观察组和对照组患者NRS评分均较治疗前明显降低(t=10.116,P<0.001;t=7.477,P<0.001),且观察组评分明显低于对照组(t=4.045,P<0.001);观察组和对照组患者KPS、PF、EF、QL、BRFU评分均较治疗前明显升高(观察组:t=13.361,P<0.001;t=5.229,P<0.001;t=6.969,P<0.001;t=4.511,P<0.001;t=4.144,P<0.001;对照组:t=4.575,P<0.001;t=2.938,P<0.001;t=4.578,P<0.001;t=2.760,P<0.001;t=2.437,P<0.001),且观察组均明显高于对照组(t=13.346,P<0.001;t=2.190,P=0.032;t=3.064,P=0.003;t=2.361,P=0.021;t=2.195,P=0.032)。观察组和对照组患者用药后药物不良反应恶心呕吐、便秘、骨痛加剧、发热发生率比较差异均无统计学意义(χ^(2)=0.000,P=1.000;χ^(2)=0.000,P=1.000;χ^(2)=0.516,P=0.472;χ^(2)=0.000,P=1.000)。结论盐酸羟考酮缓释片联合注射用唑来膦酸治疗晚期BCBM同期放化疗患者能减轻患者癌痛,改善患者身体功能状态,提高患者生活质量,且安全性较好。

Objective To explore the effect of oxycodone hydrochloride sustained-release tablets combined with zoledronic acid for injection on cancer pain and quality of life of advanced breast cancer bone metastasis(BCBM)patients treated with concurrent chemoradiotherapy.Methods A total of 62 patients with advanced BCBM treated with concurrent chemoradiotherapy were selected in the Anyang Tumor Hospital from Jan,2017 to Mar,2019.They were divided into the control group and the observation group according to the random number table,with 31 patients in each group.In the control group,zoledronic acid for injection was used to treat patients with advanced BCBM treated with concurrent chemoradiotherapy.In the observation group,oxycodone hydrochloride sustained-release tablets were added to the treatment of the control group.The course of treatment was 12 weeks.The pain degree[Numeric rating scale(NRS)score],physical function status(KPS score)and quality of life[quality of life measurement scale for breast cancer patients(QLQ-BR53)]of patients in the two groups were compared before treatment and in 12 weeks after treatment score;the occurrence of adverse drug reactions was observed and recorded in the two groups.Results After 12 weeks of treatment,the NRS scores of the observation group and the control group were significantly lower than before treatment(t=10.116,P<0.001;t=7.477,P<0.001),and the NRS score of the observation group was significantly lower than that of the control group(t=4.045,P<0.001).After 12 weeks of treatment,the KPS,RPF,EF,QL,BRFU scores of the observation group and the control group were significantly higher than before treatment(in the observation group:t=13.361,P<0.001;t=5.229,P<0.001;t=6.969,P<0.001;t=4.511,P<0.001;t=4.144,P<0.001;in the control group:t=4.575,P<0.001;t=2.938,P<0.001;t=4.578,P<0.001;t=2.760,P<0.001;t=2.437,P<0.001),and the KPS,RPF,EF,QL,BRFU scores of the observation group were significantly lower than those of the control group(t=13.346,P<0.001;t=2.190,P=0.032;t=3.064,P=0.003;t=2.361,P=0.021;t=2.195,P=0.032).There was no difference in the incidences of nausea and vomiting,constipation,bone pain,fever between the observation group and the control group(χ^(2)=0.000,P=1.000;χ^(2)=0.000,P=1.000;χ^(2)=0.516,P=0.472;χ^(2)=0.000,P=1.000).Conclusion Oxycodone hydrochloride sustained-release tablets combined with zoledronic acid for injection in the treatment of advanced BCBM patients treated with concurrent chemoradiotherapy can alleviate the cancer pain,improve the physical function status and quality of life of the patients,and the safety is good.