唑来膦酸钠联合^(89)SrCl_2治疗骨转移瘤的临床疗效

Clinical observation of zoledronic acid combined with ^(89)SrCI_2 in the treatment of bone metastasis tumor

目的:评估^(89)SrCl_2联合唑来膦酸钠在恶性肿瘤骨转移治疗中的临床疗效。方法:95例恶性肿瘤骨转移患者随机分为三组,实验组32例应用^(89)SrCl_2联合唑来膦酸钠治疗,另外两组设为对照组,分别单纯给以^(89)SrCl_2或唑来膦酸钠治疗。随访观察6个月,根据治疗后疼痛缓解和全身骨扫描结果判断疗效。结果:实验组疼痛缓解总有效率为87.50%(28/32),对照组分别为77.42%(24/31)、75.00%(24/32)。实验组和对照组疼痛缓解改善比较差异有统计学意义(P<0.05)。实验组骨转移病灶好转或消退总有效率为34.38%(11/32),对照组分别为32.26%(10/31)、31.25%(10/32),实验组和对照组病灶改善比较差异无统计学差异(P>0.05)。实验组观察唑来膦酸钠的给药时间,一周内和一月后给药骨痛缓解总有效率分别为64.71%(11/17),66.67%(10/15),疼痛改善比较无统计学差异(P>0.05)。结论:^(89)SrCl_2联合唑来膦酸钠治疗恶性骨转移癌缓解骨痛优于单独给药。^(89)SrCl_2和唑来膦酸钠联合给药不存在拮抗和竞争,可以同时联合使用。

Objective: To evaluate the effect of 89SrCl2 combined with zoledronic acid for treatment of metastatic bone tumors,and to explore the significance of collaborative treatment. Methods: All 95 patients were divided into three groups randomly. 32 cases in experimental group accepted treatment of 89SrCl2 combined with zoledronic acid.The other two control groups（ n = 31,n = 32） accepted treatment with 89SrCl2 or zoledronic acid. Results: 28 cases of32 in experimental group patients were with varying degrees of relief with the total efficiency 87. 50%（ 28 /32）. The other two control groups were 77. 42 %（ 24 /31） and 75. 00%（ 24 /32） respectively. Effect of pain palliation had significant difference（ P < 0. 05）. The regression of bone metastatic lesions in experimental group and control groups were 34. 38%（ 11 /32）,32. 26%（ 10 /31）,31. 25%（ 10 /32） respectively. No significant difference was observed（ P >0. 05）. Administration of zoledronic acid in experimental group within a week and after a month,the rates of pain palliation were 64. 71%（ 11 /17）,66. 67%（ 10 /15） respectively. No significant difference was observed（ P > 0. 05）.Conclusion: Administration of 89SrCl2 combined with zoledronic acid has good effect of pain palliation with bone metastases than single administration of 89SrCl2 or zoledronic acid. 89SrCl2 and zoledronic acid combination is not competitive and antagonistic,which may be used simultaneously.