重复负荷剂量伊班膦酸钠治疗乳腺癌骨转移疼痛的临床疗效

Clinical efficacy of repeated loading dose of ibandronate sodium in treatment of bone metastatic pain in breast cancer

目的评价负荷剂量伊班膦酸钠重复给药治疗乳腺癌骨转移诱导的复发性中重度疼痛的近期疗效和安全性。方法自2020—2021年间,共纳入61例伊班膦酸钠首次负荷剂量治疗有效后至少1个月后复发的乳腺癌骨转移所致中重度骨痛患者,予以重复负荷剂量伊班膦酸钠治疗。评价指标:疼痛评分、止痛药用量和不良反应。结果重复使用负荷量伊班膦酸钠后,骨痛在3~7 d内明显缓解,平均时间(5.0±1.4)d。与治疗前比较,治疗后疼痛评分明显降低[治疗前为(6.1±1.3)分,第7、14、21天分别为(4.3±1.7)、(2.9±2.0)、(2.4±2.1)分,P均<0.001];同时,镇痛剂用量明显减少[口服吗啡等效日剂量治疗前为(90.0±27.0)mg,第7、14、21天分别为(60.2±23.6)、(48.0±22.2)、(43.3±22.1)mg,P均<0.001]。患者的功能状态有所改善。治疗期间患者未表现出肝肾毒性,治疗耐受性良好。结论负荷剂量伊班膦酸钠重复给药方案可能是改善乳腺癌骨转移患者复发性中重度骨痛的一种安全有效的方法。

Objective To evaluate the short-term efficacy and safety of repeated administration of loading dose of Ibandronate Sodium in the treatment of recurrent moderate and severe pain induced by bone metastasis in breast cancer.Methods From 2020 to 2021,a total of 61 patients with moderate to severe bone pain caused by bone metastases of breast cancer recurred at least 1 month after receiving an effective initial loading dose of Ibandronate Sodium were enrolled,and treated with repeated loading dose of Ibandronate Sodium.Evaluation indicators:pain score,analgesic consumption,and adverse events.Results After repeated use of loading dose of Ibandronate Sodium,bone pain was significantly relieved within 3 to 7 days,with a mean duration of 5.0±1.4 days.Compared with the pain score of 6.1±1.3 before treatment,the pain scores were decreased at day 7,14 and 21,with the pain score of 4.3±1.7,2.9±2.0,and 2.4±2.1,respectively(all P<0.001).Analgesic consumptions were markedly decreased(mean oral morphine equivalent daily dose:60.2±23.6 mg,48.0±22.2 mg,and 43.3±22.1 mg at day 7,14 and 21,versus 90.0±27.0 mg before treatment,all P<0.001).The patient′s functional status improved.During the treatment,no nephrotoxicity was demonstrated and the treatment was well tolerated.Conclusions Repeated administration of loading dose of Ibandronate Sodium may be a safe and effective way to improve the recurrent moderate and severe bone pain in breast cancer patients with bone metastases.