容积旋转调强放疗联合唑来膦酸治疗椎体转移瘤患者的临床效果

Clinical efficacy of volumetric modulated arc radiotherapy combined with zoledronic acid in the treatment of vertebral metastases

目的探讨容积旋转调强放疗(VMAT)联合唑来膦酸治疗椎体转移瘤的临床优势。方法选取2015年1月至2017年12月间青岛市肿瘤医院收治的78例椎体转移患者,按照放射治疗技术不同分为研究组38例和对照组40例。研究组采用VMAT联合唑来膦酸治疗,对照组采用普通三维适形放疗(3D-CRT)联合唑来膦酸治疗,比较两组患者的局部控制率、疼痛缓解率及局部无进展生存率等疗效评价指标。结果研究组患者局部控制率为97. 4%,疼痛缓解率为100. 0%,治疗后3个月和6个月的局部无进展生存率分别为89. 5%和73. 7%;对照组患者局部控制率为80. 0%,疼痛缓解率为82. 5%,治疗后3个月和6个月的局部无进展生存率分别为70. 0%和50. 0%,两组比较,差异均有统计学意义(均P <0. 05)。结论容积旋转调强放疗联合唑来膦酸治疗椎体转移瘤患者,能提高局部控制率,缓解骨痛,局部无进展生存率更高。

Objective To investigate the clinical advantage of volumetric modulated arc therapy(VMAT)combined with zoledronic acid in the treatment of vertebral metastases.Methods A total of 78 patients with vertebral body metastases admitted to Qingdao Cancer Hospital from January 2015 to December2017 were selected and randomly divided into a study group(38 patietns)and a control group(40 patients)according to the radiotherapy techniques.Patients in study group were treated with VMAT combined with zoledronic acid and the control group was underwent ordinary three-dimensional conformal radiotherapy(3 DCRT)combined with zoledronic acid.The local control rate,pain relief rate,local progression-free survival rate were compared between the two groups.Results The local control rate was 97.4%and the pain relief rate was 100.0%respectively in the study group(P<0.05).The 3-month and 6-month local progressionfree survival rates respectively 89.5%and 73.7%,respectively for the observation group(P<0.05).For the control group,the local control rate was 80.0%,the pain relief rate was 82.5%and the 3-month and 6-month local progression-free survival rate was 70.0%and 50.0%,respectively(all P<0.05).Conclusion VMAT combined with zoledronic acid can better improve the local control rate,pain relief,and local progression-free survival rate.