放射治疗联合唑来膦酸治疗骨转移癌疗效观察

目的:分析放射治疗联合唑来膦酸治疗骨转移癌疼痛的疗效及不良反应。方法:应用局部止痛性外照射、唑来膦酸联合治疗34例骨转移癌疼痛患者,随访观察3个月,选择未联合使用唑来膦酸的38例患者作为对照。根据治疗后疼痛缓解和生活质量变化判断疗效,依据临床症状、血常规、电解质等变化观察不良反应。结果:综合治疗组总有效率为88.2%(30/34),其中完全缓解(CR)率52.9%(18/34),部分缓解(PR)率29.4%(10/34),无缓解(NR)率11.8%(4/34)。主要不良反应为恶心和食欲下降(8例),全身乏力(7例),一过性发热(2例)。用药前后血钙、血磷、血镁的差异无统计学意义(P>0.05)。与对照组相比,综合治疗更为有效(P<0.05)。结论:采用放射治疗联合唑来膦酸治疗骨转移癌疼痛是一种有效的综合治疗方法,可提高患者生存质量。

Clinical observation of treating metastatic bone cancer with external radiation and zoledronic acid

Objective:To evaluate the effect of external radiation and zoledronic acid in therapy of metastatic cancer bone pain. Methods: Thirty four inpatients with metastatic bones were treated with comprehensive therapy in our department during the period from November 2004 to August 2005. External radiation dose was 30Gy~60Gy/2~6 weeks; 4mg zoledronic acid was intravenously given two times after radiotherapy. 38 inpatients as control group were not treated by zoledronic acid. Results: Complete relief of bone pain was observed in 18 cases (52.9%), partial relief in 10 cases (29.4%) and no relief in 4 cases (11.8%). Total pain relief rate was 88.2 %( 30/34). Side-effects related to the therapy were naupathia and anorexia (in 8 cases), general tiredness (in 7 cases). To inspect all inpatients' serum calcium, phosphorus and magnesium before and after using zoledronic acid, there were no difference (P>0.05). Comparing with the control group, the comprehensive therapy group was more effectire(P<0.05). Conclusion: Combined therapy of external radiation, intravenous injection and zoledronic acid was comprehensive and effective method to relieve metastatic cancer bone pain and increase the patient s life quality.