乳腺癌骨转移同位素与双膦酸盐治疗的对比研究

目的对比分析同位素（^89SrCl2）与双膦酸盐（帕米膦酸二钠）治疗乳腺癌骨转移的疗效。方法以108例乳腺癌骨转移患者为研究对象，其中^89SrCl2组41例，帕米膦酸二钠组36例，联合用药组31例。进行临床对比观察。结果^89SrCl2组和帕米膦酸二钠组对镇痛总有效率分别为80．5％和80．6％，对骨转移病灶总有效率分别为17．1％和8．3％，生活质量总改善率分别为48．9％和44．4％，以上两组3个指标比较差异均无统计学意义（P〉0．05）。而联合用药组镇痛总有效率为90．6％，和^89SrCl2组、帕米膦酸二钠组相比差异无统计学意义（P〉0．05），但是联合用药组对骨转移病灶有效率和生活质量总改善率分别为48．4％和74．2％，并且和^89SrCl2组、帕米膦酸二钠组比较差异有统计学意义（P〈O．05）。108例患者不良反应均较小。结论^89SrCl2和帕米膦酸二钠在治疗乳腺癌骨转移中，对镇痛及骨转移病灶和生活质量改善有同等较好的疗效。应用^89SrCl2和帕米膦酸二钠联合治疗不仅可以显著提高疗效而且不良反应无明显增加。

Comparison of isotope therapy and bisphosphonates therapy for bone metastasis of breast cancer

Objective To compare the efficaey of isotope therapy with bisphosphonates therapy for bone metastasis of breast cancer. Method A total of 108 patients with bone metastasis caused by breast cancer were enrolled in this study, who were assigned into 3 groups to receive medication with exclusive ^89SrCl2, （ n = 41 ）, exclusive pamidronate disodium for injection （ n = 36） and combination of these 2 drugs （ n = 31 ）. A follow-up study lasting for 3 months was conducted. Results In view of the total pain-relief rates of the bone, ^89SrCl2, pamidronate disodium for injection and their combination did not make significant difference （80.5% ,80.6% and 90.6% ,P 〉 0.05）. As for the rates of the bone lesion improvement, 17.1% ,8.3% and 48.4% were achieved through the 3 medical protocols respectively, showing significantly better effect produced by the combination of the 2 drugs （P 〈 0.05 ）. The rates of improvement in the quality of life were the same with the bone lesion improvement when combined medication a rate as much as 74.2%, significantly better than those of their separate uses （ 48.9% and 44.6% ,P 〈 0.05 ）. The side effects were minimal in all the cases. Conclusion ^89SrCl2 and pamidronare disodium for injection are both effective and safe for treating bone metastasis caused by breast cancer, and their combination can produce more desirable effects.