负荷量伊班膦酸钠治疗恶性肿瘤骨转移的疗效

Clinical effect of loading dose of ibandronate in the treatment of bone metastases of malignant cancer

目的观察负荷量伊班膦酸钠治疗恶性肿瘤转移性骨痛的疗效和安全性。方法 30例晚期恶性肿瘤骨转移患者,给予负荷量伊班膦酸钠6 mg/d,连续用3 d(共18 mg)。观察并记录止痛起效的时间、疼痛评分、生活质量KPS评分、吗啡日耗量、血钙、碱性磷酸酶和肾功能等的变化。结果治疗后23例患者疼痛缓解,缓解率76.7%,疼痛缓解平均所需时间(4.48±0.28)d,治疗后疼痛评分改善、生活质量评分提高(P<0.01);有7例患者治疗后吗啡每日用量减少20~60 mg。治疗前6例患者血钙增高,治疗后均降至正常范围;不良反应少,未出现肾脏毒性反应。结论伊班膦酸钠负荷量给药止痛起效快,可迅速改善转移性骨痛,减少吗啡用量,提高患者的生活质量,并能有效降低血钙及碱性磷酸酶,疗效显著。

Objective To investigate the efficiency and safety of loading dose of ibandronate treating bone metastases of malignant cancer.Methods 30 cases of malignant cancer with bone metastases were analyzed retrospectively.Ibandronate was administered intrave-nously 6 mg for 3 days( total dose of 18 mg ) .The respond time, pain score, QOL score, daily morphine consumption dose were recorded. The serum calcium, alkaline phosphatase ( AKP) and creatinine were monitored.Results After treatment, the rate of pain relief in 23 cases was 76.7%.Their average response time was (4.48±0.28)d.The pain score was significantly decreased after treatment and the life quali-ties of patients were markerly improved (P<0.01 ).The morphine daily comsumption dose was reduced about 20~60 mg in 7 cases after treatment.Hypercalcemia was found in 6 patients before treatment and the serum calcium level was declined to the normal level after treat-ment.Ibandronate was well tolerated with no evidence of renal toxicity.Conclusions Administration of ibandronate loading dose has quick onset and could relieve metastasis bone pain, improve life quality, reduce the consumption of morphine and effectively decrease serum calci-um level, which is worthy of clinical popularization and application.