【伊班膦酸钠联合放疗治疗骨转移癌的疗效观察】 伊班膦酸钠治疗骨转移
[摘要] 目的 观察伊班膦酸钠配合放疗治疗恶性肿瘤骨转移疗效及毒副反应。方法 96例患者随机分为治疗组和对照组，治疗组45例患者每4周应用伊班膦酸钠4 mg加入生理盐水500 mL静滴4 h以上，每位患者应用4～6次，同时联合放疗200 cGy/次，每周5次，DT 3 000～5 000 cGy；对照组51例单纯应用放疗。 结果 治疗组骨痛缓解率为88.9%，对照组为68.6%，差异有统计学意义（P ＜ 0.05）；治疗组治疗骨转移灶总有效率为68.9%，对照组为31.4%，差异有统计学意义（P ＜ 0.05）；KPS评分改善率治疗组为80.0%，对照组为58.8%，差异有统计学意义（P ＜ 0.05）。 结论 伊班膦酸钠联合放疗治疗恶性肿瘤骨转移取得满意疗效，不良反应轻微，可改善预后，提高患者生存质量。
[关键词] 伊班膦酸钠；骨转移癌；放疗；KPS评分；疼痛
[中图分类号] R738.105 [文献标识码] A [文章编号] 1673-7210（2012）07（b）-0069-02
Effect observation of Ibandronate combined with radiotherapy in the treatment of bone metastases
LI Jing1 WANG Enyan2 WANG Chunyu1
1.Department of Oncology, the General Hospital of PetroChina North China Oilfield Company, Hebei Province, Renqiu 062552, China; 2.Department of Intensive Care Unit, the General Hospital of PetroChina North China Oilfield Company, Hebei province, Renqiu 062552, China
[Abstract] Objective To compare the effects and toxicity of Ibandranate combined with radiotherapy in the treatment of bone metastases. Methods 90 patients with metastatic bone cancer were randomized into two groups, 45 patients of the treatment group received radiotherapy: 200 cGy,5 times a week, DT 3 000-5 000 cGy, combined with 4-6 cycles of monthly intravenous Ibandronate 4 mg and 51 patients of the control group were treated with radiotherapy alone. Results The response rate of pain relief was 88.9% in the treatment group and 68.6% in the control group, with statistically significant difference (P ＜ 0.05). The response rate of managing bone metastasis focus was 68.9% in the treatment group and 31.4% in the control group, with statistically significant difference (P ＜ 0.05). The response rate of KPS score was 80.0% in the treatment group and 58.8% in the control group, with statistically significant difference (P ＜ 0.05). Conclusion Ibandronate combined with radiotherapy has notable clinical response and the treatment was well tolerated. It can improve the prognosis and the quality of life.
[Key words] Ibandronate; Metastatic bone cancer; Radiotherapy; KPS score; Pain
骨转移是恶性肿瘤疾病进展的晚期阶段，尤其常见于乳腺癌、肺癌、前列腺癌、肾癌和甲状腺癌等。骨痛和病理性骨折是恶性肿瘤骨转移常见的临床症状，其可严重影响患者的生活质量，甚至可导致死亡[1]。放疗可以控制骨转移灶并减轻症状，提高生活质量。在恶性肿瘤骨转移的治疗用药上，伊班膦酸钠是目前主流治疗药物，其可抑制肿瘤细胞对骨的黏附和侵袭作用，防治骨质疏松，减轻疼痛症状[2]。我院2008年1月～2011年12月采用伊班膦酸钠联合放疗治疗45例恶性肿瘤骨转移患者，疗效满意，现报道如下：
1 资料与方法
1.1 一般资料
2008年1月～2011年12月96例患者入组，其中，男54例，女42例；年龄28～75岁，平均（54.6±9.2）岁；肺癌44例，乳腺癌34例，大肠癌7例，前列腺癌5例，宫颈癌4例，食管癌2例。所有患者KPS评分≥60分，预计生存期＞6个月，心、肝、肾功能及血白细胞正常。将其分为治疗组（45例）和对照组（51例）。两组患者一般资料比较差异无统计学意义（P ＞ 0.05），具有可比性。