双膦酸盐治疗恶性肿瘤骨转移并恶性高钙血症的临床分析  

Clinical Analysis of Treatment on Bone Metastases and Hypercalcemia of Malignancy in Advanced Solid Tumor

作　　者：明树红[1] 孙铁英[1] 

机构地区：[1]卫生部北京医院呼吸科

出　　处：《医学临床研究》2006年第5期650-652,共3页Journal of Clinical Research

摘　　要：【目的】探讨唑来膦酸和帕米膦酸治疗恶性肿瘤骨转移并恶性高钙血症的有效性和耐受性。【方法】采用开放、对照研究方法,病理或细胞学证实的恶性肿瘤患者经ECT和X线或CT或MRI证明骨转移且校正血清钙值(CSC)≥12.0 mg/dl,接受唑来膦酸4 mg加入生理盐水注射液100 ml中静脉滴注15 min或帕米膦酸60 mg加入生理盐水注射液500 ml中静脉滴注至少4 h,定期追踪观察患者的疼痛(NRS)、CSC水平并对临床、血尿常规、肝肾功能进行监测。【结果】20例肿瘤骨转移并高钙血症患者,唑来膦酸治疗12例,帕米膦酸8例,经治疗后疼痛明显缓解(唑来膦酸:5.92 vs 3.25,P<0.01;帕米膦酸:6.13 vs 4.38,P<0.01);血钙浓度较治疗前明显下降(唑来膦酸:12.86 vs 10.28 mg/dl,P<0.01;帕米膦酸:13.19 vs 10.36 mg/dl,P<0.01);CSC的有效率均为90%左右。1例帕米膦酸治疗后3 h出现低热,未作特殊处理好转;血尿常规、肝肾功能无明显异常加重的趋势。【结论】唑来膦酸和帕米膦酸对恶性高钙血症有明显疗效,耐受性良好。[Objective]To evaluate the efficacy and toleration of bisphosphonates therapy in carcinoma patients with bone metastases and hypercalcemia of malignancy. [Methods] Patients with histological or cytological confirmation cancer and hypercalcemia with bone metastases were designed to open treatment with either 4mg zoledronic acid or 60mg pamidronate. The primary efficacy parameters were pain scores（NRS）, corrected serum calcium（CSC） and C.SC effective rate. The vital signs, biochemical and hematological parameters were determined. [Results]Twenty patients were enrolled in this study, twelve patients in zoledronic acid and eight in pamidronate group, zoledronic acid and pamidronate significantly palliated pain. Pain scores were significantly lower at end-point after zoledronic acid or pamidronate infusion（5.92 vs 3.25, P 〈0.01; 6.13 vs 4.38, P 〈0. 01, respectively）. The mean CSC level decreased significantly after Zoledronic acid or pamidronate infusion from 12.86 to 10. 28mg/dl and 13.19 to 10. 36mg/dl respectively. The CSC effective rate was about 90% in zoledronic acid group and pamidronate group. There was not statistically significant for all primary efficacy parameters in zoledronic acid group compared with pamidronate group. An adverse reaction was mild fever after pamidronate infusion and then completely reversible. [Conclusions]Zoledronic acid and pamidronate disodium are well tolerated and effective for bone metastases and hypercalcemia of malignancy in advanced solid tumor.

关 键 词：肿瘤/并发症 骨肿瘤/继发性 高钙血症/药物疗法 肿瘤转移 

分 类 号：R738.1[医药卫生—肿瘤]