唑来膦酸治疗76例恶性肿瘤骨转移性疼痛  

A clinical study for Zoledronic acid in the relief of pain due to bone metastatic malignancy

作　　者：陶莉[1] 王洪林[1] 陈剑[1] 李纲[1] 王妹兴[1] 李安琪[1] 王中吉[1] 

机构地区：[1]复旦大学附属上海市第五人民医院肿瘤内科肿瘤放疗科,上海200240

出　　处：《中国癌症杂志》2006年第12期1057-1059,共3页China Oncology

摘　　要：背景与目的：双磷酸盐被广泛的用于治疗肿瘤骨转移或多发性骨髓瘤引起的骨破坏，其机制是抑制破骨细胞介导的骨吸收。现有的双磷酸盐中，唑来膦酸是在世界上应用最广泛的一种，几乎用于所有的实体瘤骨转移的治疗。本研究探讨唑来膦酸治疗恶性肿瘤骨转移性疼痛的镇痛效果和不良反应。方法：76例恶性骨转移性疼痛的患者每次给予唑来膦酸注射液4mg，用100ml生理盐水或5％葡萄糖注射液稀释后静脉滴注，每3～4周一次，至少连续2次。结果：临床镇痛骨转移灶止痛效果：完全缓解18．4％（14／76），明显缓解26．3％（20／76），中度缓解34．2％（26／76），轻度缓解21．1％（16／76），中位起效缓解时间第4天，中位缓解持续时间27d。主要不良反应为发热、消化道反应、短暂性骨痛加重、肌酐轻度升高、低血膦及低血钙，但反应轻，不需特殊处理。结论：唑来膦酸治疗恶性肿瘤骨转移有明显镇痛效果，药效维持时间较长，使用方便，不良反应轻，患者容易接受。Background and purpose： Bisphosphonates are widely used to treat the patients with bone metastases, the rational is that Bisphosphonates could inhibit bone resorption in which osteoelast involve. Bisphosphonates have also demonstrated antitumor activity in preclinical models. Of commercial available bisphosphonates, intravenous zoledronic acid is one of the most use in the clinic and is proved to be very effective for the treatment of bone metastases. This study is to investigate the effect and adverse effect of Zoledronic acid in the treatment of osseous metastases pain of malignant tumor. Methods： 76 patients who have osseous metastases pain were treated with 4 milligram Zoledronic acid injection diluted with 100 milliliter physiologic saline or 5% Glucose injection by intravenous drip infusion per 3 to 4 weeks. Two cycles of Zoledronic acid injection have to be finished at least before the response can be evaluated. Results： The effect of pain relieving by Zoledronic acid injection were the following： 18.4% （14/76） had reached completely relief, 26.3% （20/76） obvious relief, 34.2% （26/76） midrange relief and 21.1/76（16/76） lightly relief. The median time of the relief was 4 days. The median duration of the relief was 27 days. Main adverse effects were febricity, upset of digestive tract, temporal aggravation of the pain, lightly increasing of creatinine, low phosphonium or calcium in blood. Most of the adverse effects did not require medical interfere. Conclusions： The effect of malignant osseous metastasis pain treated with Zoledronic acid injection was obvious. The treatment response could be persistent for a long time, and the drug is easy to be used in the clinic and has excellent safe profile.

关 键 词：唑来膦酸 骨转移性疼痛 不良反应 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]