伊班膦酸钠联合化疗治疗骨转移癌的临床观察

目的探讨伊班膦酸钠（艾本）联合化疗治疗骨转移癌的临床疗效。方法2003年5月至2005年4月间，将74例骨转移癌患者随机分成2组：①单纯化疗组：按相应化疗方案处理；②联合治疗组：联合使用化疗及伊班膦酸钠治疗。结果止痛效果评价．单纯化疗组有效率48．6％（18／37），联合治疗组有效率为86．5％（32／37）．后者显著高于前者（P〈0．05）。骨转移灶疗效评价，单纯化疗组有效率为29．7％（11／37）．联合治疗组有效率为35．1％（13／37），二者差异无显著性意义（P〉0．05）。联合治疗组在24个月研究期间至少发生1次骨相关事件的患者比例为43％（16／37）．而单纯化疗组为57％（21／37），联合治疗组显著低于单纯化疗组（P〈0．05）。一股状况明显改善，联合治疗组及单纯化疗组的Karnofsky评分平均值分别增加18．4分和9．9分。不良反应主要为短暂低热和恶心。结论伊班膦酸钠作用强、毒性低，是临床上治疗骨转移癌、控制骨痛、减少骨相关事件的理想药物。

A Clinical Observation of Ibandronate Combined with Chemotherapy in Treatment of Metastatic Bone Cancer

Objective To study the curative effect of ibandronate combined with chemotherapy in the treatment of metastatic bone cancer.Methods From May 2003 to April 2005,74 patients with metastatic bone cancer were randomized into two groups: 37 patients in chemotherapy group received normal chemotherapy,and 37 patients in combination group were treated with both chemotherapy and ibandronate.The effects were evaluated when two cycles(6 weeks) finished.Results The overall response rate of pain relief in chemotherapy group and combination group was 48.6%(18/37) and 86.5%(32/37) respectively(P<0.05).The overall response rate of bone metastasis in chemotherapy group and combination group was 29.7%(11/37) and 35.1%(13/37) respectively(P>0.05).The proportion of patients with at least one SREs during a 24-month period was lower in combination group(43%) than in chemotherapy group(57%,P<0.05).The average Karnofsky performance status was enhanced by 9.9 and 18.4 respectively.The common side-effects were transient pyrexia and nausea.Conclusion Ibandronate combined with chemotherapy is effective for relieving pain,decreasing SREs and improving performance status,and its side-effect was mild to be tolerated.