洛屈配合局部放疗治疗恶性肿瘤骨转移疼痛临床疗效观察

为观察用洛屈配合局部放疗治疗恶性肿瘤骨转移疼痛的临床疗效 ,对确诊为恶性肿瘤骨转移的 3 1例患者予局部放疗 ,同时应用洛屈治疗。初步研究结果示 ,治疗的 3 1例患者中 ,完全缓解 (CR ) 8例 ,部分缓解 17例 ,有效率 (CR +PR)为 81% ,效果比较显著。毒副反应主要为轻度骨髓抑制和胃肠道反应 ,患者容易耐受。用洛屈配合局部放疗治疗恶性肿瘤骨转移引起的疼痛有良好疗效     

洛屈配合局部放疗治疗恶性肿瘤骨转移疼痛临床疗效观察

为观察用洛屈配合局部放疗治疗恶性肿瘤骨转移疼痛的临床疗效，对确诊为恶性肿瘤骨转移的31例患者予局部放疗，同时应用洛屈治疗。初步研究结果示，治疗的31例患者中，完全缓解(CR)8例，部分缓解17例，有效率(CR PR)为8l％，效果比较显著。毒副反应主要为轻度骨髓抑制和胃肠道反应，患者容易耐受。用洛屈配合局部放疗治疗恶性肿瘤骨转移引起的疼痛有良好疗效。     

伊班膦酸钠单药及联合化疗治疗乳腺癌骨转移的疗效分析

目的:观察伊班膦酸钠单独使用与联合化疗对乳腺癌骨转移引起的疼痛、活动功能障碍及转移病灶修复的疗效.方法: 45例乳腺癌骨转移患者随机分为治疗组23例(伊班膦酸钠单独应用)与对照组22例(伊班膦酸钠加化疗组).治疗组单独静脉滴注伊班膦酸钠4mg,每4周重复,连用2-4次;对照组采用FEC化疗方案,在化疗期间加用伊班膦酸钠,方法及剂量同上,2周期后评价疗效.结果: 止痛作用:治疗组总有效率为82.6%, 对照组90.9%,差异无显著性.活动能力改善情况:治疗组总有效率为73.9%,对照组81.8%,差异无显著性.骨转移病灶修复情况:治疗组仅2例达到PR,有效率8.7%;对照组CR 1例,PR 5例,总有效率27.3%,差异有显著性(P<0.05).结论: 单用伊班膦酸钠对乳腺癌骨转移引起的疼痛及活动障碍有较好的治疗作用.伊班膦酸钠联合化疗可以提高疗效,并可促进骨转移灶的修复.     

伊班膦酸钠联合化疗治疗转移性骨肿瘤45例疗效观察

目的 探讨伊班膦酸钠(艾本)联合化疗治疗恶性肿瘤骨转移的临床疗效.方法 45例恶性肿瘤骨转移,均用伊班膦酸钠联合化疗.结果 患者疼痛总缓解率为84%,骨病灶控制总有效率为29%,无明显毒副反应.结论 伊班膦酸钠联合化疗是目前治疗晚期恶性肿瘤骨转移的优选方案.     

伊班膦酸钠联合放疗治疗骨转移癌疼痛的临床疗效

目的观察伊班膦酸钠(艾本)联合放疗治疗骨转移癌患者疼痛的疗效。方法40例恶性肿瘤骨转移癌患者,艾本2mg~4mg溶于不含钙离子的0.9%生理盐水或5%葡萄液,缓慢静脉滴注(不少于2小时)。同时配合放疗,DT30Gy。结果治疗后完全缓解21例(52.5%),部分缓解13例(32.5%),疼痛总缓解率为85%,3例患者血钙均降至正常。结论艾本联合放疗治疗骨转移癌疼痛疗效确切,可降低高钙血症血钙浓度,预防病理性骨折的发生,提高了患者的生活质量,毒副反应轻,值得临床进一步观察。     

放射联合唑来膦酸治疗骨转移癌疼痛的疗效观察

目的: 观察唑来膦酸配合局部放疗治疗恶性肿瘤骨转移疼痛临床疗效.方法: 对确诊为恶性肿瘤骨转35例患者予局部放疗,同时应用唑来膦酸治疗.结果: 总有效率为88.6%,显效28例,无效4例.结论: 用唑来膦酸配合局部放疗治疗恶性肿瘤骨转移引起的疼痛有良好疗效,毒副作用轻,患者容易耐受.     

伊班膦酸钠联合放疗与单纯放疗治疗多发骨转移癌的疗效观察

目的比较伊班膦酸钠联合放疗与单纯放疗治疗多发骨转移癌的疗效。方法100例患者随机分为两组,伊班膦酸钠 放疗组46例,单纯放疗组54例,联合组采用伊班膦酸钠4mg加入生理盐水500ml静滴4小时以上,并保证当日液体量不低于1500ml,1次/月,每例病人应用4~6次。放疗针对最痛点,模拟机下定位,采用6MV-X线照射,DT200cGY/次,5次/W,总剂量DT4000cGY/20次/4周。单纯放疗组只采用放射治疗,方法及剂量同上。结果联合放疗组止痛总有效率91.3%,显效率58.7%。单纯放疗组总有效率为75.9%,显效率为35.2%,两组比较P<0.05,有显著差异。结论伊班膦酸钠联合放疗治疗恶性肿瘤骨转移,疗效确切,毒副反应轻微,可耐受,值得临床进一步推广应用。     

艾本与放疗联合治疗恶性肿瘤骨转移的临床疗效

目的:探讨艾本(伊班膦酸钠)全身用药与局部放疗相结合治疗恶性肿瘤局限性骨转移的临床疗效.方法:80例恶性肿瘤局限性骨转移患者随机分为两组,艾本静脉滴注加局部放疗40例(治疗组);单放组40例,只采用局部放疗(对照组).结果:治疗组疼痛缓解率为92.5%,对照组疼痛缓解率为82.5%,两组间比较无明显差异(P＞0.05);溶骨病灶再钙化的有效率治疗组为76.7%,而对照组仅为27.8%,两组比较有显著性差异(P＜0.001);治疗组出现第二部位骨转移的机率明显低于对照组(P＜0.05);1年生存率治疗组明显高于对照组(P＜0.05).两组患者不良反应的发生率相似,无显著性差异(P＞0.05).结论:艾本联合放疗治疗局限性骨转移,具有止痛快、疗效确切、高效修复溶骨病灶,并能防止新转移灶的发生及较高的生存率等优点.     

伊班膦酸钠联合放疗治疗恶性肿瘤骨转移疗效观察

骨转移癌是恶性肿瘤常见的晚期并发症之一,主要临床表现为骨痛、骨破坏、甚至病理性骨折,严重影响患者的生活质量[1].单纯放疗虽可短期改善患者的症状,减轻患者的痛苦,但易引起局部复发和再转移,这也是放射治疗失败的主要原因.近年来有学者报道采取放化疗结合的综合治疗的方法治疗骨转移取得了较好的疗效.本院采用伊班膦酸钠联合放疗治疗恶性肿瘤的骨转移亦取得了较好的疗效,现报道如下.     

艾本联合放疗治疗骨转移癌的疗效观察

 恶性肿瘤一旦发生骨转移后，常出现顽固性疼痛、运动功能障碍、病理性骨折等，严重者影响生存质量。过去常行单纯放疗和／或化疗及姑息性麻醉止痛治疗，疗效差，持续时间短。选择我院及汉口空军医院住院及门诊骨转移癌患者42例，其中22例应用第三代双膦酸制剂-伊班磷酸纳(艾本)联合放疗，疗效较好，现报告如下。     

唑来膦酸治疗癌症骨转移疼痛临床观察

目的探讨唑来膦酸治疗恶性肿瘤骨转移疼痛的疗效和安全性.方法选择恶性肿瘤骨转移中、重度疼痛患者52例,随机双盲分成两组:A组(试验组)22例:唑来膦酸4mg溶于生理盐水50ml静滴;B组(对照组)30例:博宁90mg 生理盐水750ml静滴.结果唑来膦酸镇痛效果:显效(CR):4/22,部分缓解(PR):13/22,无效(NR):5/22,总有效率(CR PR):77.27%(17/22),疗效维持时间16.4天,KPS评分平均提高20分,主要不良反应为一过性骨痛加重,发热、恶心、呕吐.对照组总有效率(RR):77.33%,疗效维持时间14.8天.结论唑来膦酸对缓解癌症骨转移疼痛有效,安全性好,病人可耐受.     

原发鼻腔透明细胞癌3例及文献复习

目的:分析原发鼻腔部透明细癌胞的起源,病理,临床特点及治疗。方法:分析本院1992年9月～2003年9月收治的3例原鼻腔透明细胞癌患者资料,均有病理证实,中位年龄为60岁;主要症状为鼻塞逐渐加重,流涕,间断性流血涕,咽部不适等。3例均行放疗,1例为肿物切除术后放疗,1例初治放疗,1例肿物切除术后放疗后骨转移行化疗,采用6MV-X线治疗2例,8MV-X线治疗1例,DT40Gy。结果:2例健在,1例死于呼吸,循环衰竭。结论:原发鼻腔部透明细胞癌较罕见,以局部浸润生长为主,发展迅速,可有淋巴道、血液转移,手术加放疗、化疗有效。     

依班膦酸钠联合放射治疗骨转移癌临床观察

目的观察依班膦酸钠联合放射治疗骨转移癌疼痛的疗效。方法59例骨转移癌患者随机分成观察组(30例)和对照组(29例)。观察组静脉滴注依班膦酸钠4 mg,联合放射治疗40Gy,1个月后再静脉滴注依班膦酸钠4 mg;对照组仅用放疗。结果观察组和对照组止痛有效率分别为90.0%和82.7%(P>0.05),多发骨转移癌观察组与对照组止痛有效率分别为86.7%和51.7%(P<0.05)。随访2个月后观察组与对照组止痛有效率分别为86.6%和62.0%(P<0.05〉。结论依班膦酸钠联合放射治疗骨转移癌疼痛疗效优于单纯放疗。     

Effects of long-term intravenous ibandronate therapy on skeletal-related events, survival, and bone resorption markers in patients with advanced multiple myeloma.

PURPOSE: Bisphosphonates have been found to reduce the incidence of skeletal-related events (SREs) in patients with multiple myeloma. This is the first double-blind, randomized, placebo-controlled study to assess the efficacy of ibandronate, a third-generation amino-bisphosphonate, in preventing SREs in advanced-stage multiple myeloma patients. PATIENTS AND METHODS: Patients with multiple myeloma stage II or III were randomly assigned to receive either ibandronate 2 mg or placebo as a monthly intravenous (IV) bolus injection for 12 to 24 months in addition to conventional chemotherapy. SREs such as peripheral pathologic or vertebral fractures, hypercalcemia, severe bone pain, and bone radiotherapy or surgery were analyzed. Bone-turnover markers were also studied. Finally, post hoc analyses of bone morbidity and survival were performed. RESULTS: Ninety-nine patients per treatment group were assessable for efficacy analysis. The occurrence of SRE per patient year and the time to first SRE were not significantly different between the two treatment groups. In overall evaluation, no differences were found between the treatment groups regarding bone pain, analgesic drug use, quality of life, and median survival (33.1 v 28.2 months, respectively). Explorative post hoc analyses revealed that ibandronate patients with strongly suppressed bone-turnover markers (> or = 30% and > or = 50% mean reduction of serum osteocalcin and urinary C-terminal telopeptides) developed significantly less bone morbidity. Ibandronate was tolerated well during as many as 25 therapy cycles. CONCLUSION: Monthly injections of ibandronate 2 mg IV neither reduced bone morbidity nor prolonged survival in the overall population of stage II/III multiple myeloma patients.     

Combination ibandronate and radiotherapy for the treatment of bone metastases: clinical evaluation and radiologic assessment

PURPOSE: Ibandronate is a single-nitrogen, noncyclic bisphosphonate with proven efficacy for reducing metastatic bone pain. In this study, we assessed the palliative effects of combined ibandronate and radiotherapy. METHODS AND MATERIALS: Forty-five patients with bone metastases from various solid tumors received external-beam radiotherapy, 30-40 Gy over 3-4.5, weeks combined with 10 cycles of monthly intravenous ibandronate, 6 mg. RESULTS: After combined therapy, mean bone pain scores (graded from 0 to 10) were reduced from 6.3 at baseline to 0.8 after 3 months, with further reductions at later time points (all p < 0.001). Opioid use decreased from 84% of patients at baseline (38/45) to 24% (11/45) at 3 months, with further subsequent reductions (all p < 0.001). Mean performance status and functioning scores also significantly improved. Bone density (assessed by computed tomography scan) increased by 20% vs. baseline at 3 months, 46% at 6 months, and 73% at 10 months (all p < 0.001). Lesion improvement was also demonstrated by magnetic resonance imaging. Treatment was well tolerated with no renal toxicity. CONCLUSIONS: In this pilot study, combined radiotherapy and ibandronate provided substantial bone pain relief and increased bone density. Computed tomography-based or magnetic resonance imaging-based evaluations offer objective methods for assessing therapeutic outcomes.     

两种双膦酸盐治疗恶性肿瘤骨转移疼痛的药物经济学分析(英文)

目的:研究唑来膦酸和伊班膦酸钠治疗恶性肿瘤骨转移疼痛的药物经济学。方法:45例恶性肿瘤骨转移疼痛的患者随机分为两组,一组接受4mg唑来膦酸治疗,另一组接受4mg伊班膦酸钠治疗,比较两组患者首次住院双膦酸盐治疗的总费用、费用组成、疼痛缓解率、不良反应,进行药物经济学的费用-效果分析。结果:唑来膦酸组(n=23)总费用低于伊班膦酸钠组(n=22),分别为2 409.22元和3 903.64元(P<0.05);两组疼痛缓解有效率分别为78.3%和72.3%,无显著性差异(P>0.05);两组费用-效果比为31.75和53.99;不良反应发生率两组间无显著性差异(P>0.05)。结论:唑来膦酸是治疗恶性肿瘤骨转移的安全、有效、经济的药物。     

Efficacy and safety of ibandronate in the treatment of opioid-resistant bone pain associated with metastatic bone disease: a pilot study.

PURPOSE: Bone metastases are associated with severe and sometimes intractable pain, compromising patient quality of life (QOL). This open-label pilot study investigated the effects of short-term intensive treatment with intravenous (i.v.) ibandronate on opioid-resistant bone pain in patients with skeletal metastases. PATIENTS AND METHODS: Eighteen patients with advanced tumors and metastatic bone disease received nonstandard treatment with 4 mg of ibandronate administered i.v. (2-hour infusion) for 4 consecutive days (16-mg total dose). Baseline opioid analgesic use was equivalent to 400 mg/d of morphine. Patients were assessed for 6 weeks or until death. Changes from baseline were determined for bone pain, opioid consumption, patient functioning, QOL, performance status, and biochemical markers of calcium metabolism and bone turnover. Renal function was assessed by serum urea and creatinine measurement. RESULTS: Short-term, intensive ibandronate treatment significantly reduced bone pain scores within 7 days (P <.001). Pain reductions were sustained over the study period. Ibandronate significantly improved QOL, patient functioning, and performance status (P <.05). Mean values of the urinary cross-links pyridinoline and deoxypyridinoline tended to increase after day 21, returning close to baseline values by day 42. There was no correlation between the change in crosslinks values and the change in pain scores after ibandronate treatment. Ibandronate was well tolerated, with no evidence of renal toxicity. CONCLUSION: Nonstandard, intensive treatment with i.v. ibandronate seems to have a marked analgesic effect in patients with opioid-resistant bone pain from metastatic bone disease. Further investigation is warranted.