唑来膦酸治疗恶性肿瘤骨转移引起疼痛的临床研究

目的探讨唑来膦酸治疗骨转移引起疼痛的效果和不良反应。方法将恶性肿瘤骨转移引起疼痛的68例患者随机分为两组，治疗组34例，采用唑来膦酸4mg静脉滴入（15min以上），每4wk重复1次；对照组34例，采用帕米膦酸二钠90mg静脉滴入4h，每4wk重复1次，至少连续应用2次。结果缓解总有效率：治疗组、对照组分别为82．4％和79．4％，P=0.920；疼痛缓解后复发时间：治疗组和对照组分别为14．8d、13．9d，P=0．763；活动能力改善率：治疗组和对照组分别为76．5％、73．5％；KPS评分提高程度：治疗组和对照组分别为11．2、10．3分，P=0．958；不良反应发生率：治疗组和对照组分别为41．2％、44．1％，主要为发热、寒战、一过性骨痛加重、消化道反应等，两组间差异无显著性，P〉0．05，经对症处理后症状消失。结论唑来膦酸对骨转移引起的疼痛有良好的止痛效果，两组疗效无显著差异，毒副反应各有不同。

Clinical study of zoletronic acid in treatment of pain caused by bone metastasis of malignance neoplasms

Objective To evaluate the clinical effects of zoletronic acid on bone metastasis of malignance neoplasms and toxicities. Methods All 68 cases with bone pain of bone malignance metastasis were randomly divided into two groups. In the treatment group, 34 patients received zoletronic acid （4mg , to repeat every 4 weeks）. In the contrast group, 34 patients received pamidronate （90mg, to repeat every 4 weeks）, at least applying twice successively. Results Both response rates of bone pain relief were 82.4% and 79.4% in the zoletronic acid group and pamidronate group（P=0.920）, respectively. The time from relief to relapse was 14.8 days or 13.9 days in the zoletronic acid group and pamidronate group （P=0.763）, respectively. KPS increased 11.2 score and 10.3 score in the zoletronic acid group and pamidronate group （P=0.958）, respectively. The incidence rates of toxicities were 41.2% and 44.1% in the zoletronic acid group and pamidronate group, respectively. All main adverse effects including fever, chill, temporal aggravation of the pain, and upset of digestive tract could be cured. Conclusions Zoletronic acid might relive bone pain of metastasis effectively with little side effect.