三维适形放疗联合唑来膦酸治疗转移性骨肿瘤的临床探讨  

Clinical study of three dimensional conformal radiation therapy combined with zoledronic acid for bone metastases of malignant tumor

作　　者：张汀荣[1] 许晨[1] 赵韬[1] 顾小伟[1] 林青凤[1] 

机构地区：[1]东南大学附属江阴医院肿瘤科,江苏省江阴市214400

出　　处：《实用老年医学》2010年第4期322-324,共3页Practical Geriatrics

摘　　要：目的观察三维适形放疗联合唑来膦酸治疗转移性骨肿瘤的疗效和不良反应。方法 58例老年转移性骨肿瘤患者,其中35例用三维适形放疗联合唑来膦酸治疗方案(联合组),将唑来膦酸4mg加入0.9%氯化钠注射液100ml中静脉滴注,滴注时间不少于15min,每3～4周1次,共4次。骨转移灶局部给予三维适形放疗,共行4000Cgy,4周内分20次完成。另外23例患者单纯使用唑来膦酸治疗(单药组)。比较治疗前后2组患者的疼痛缓解率、生活质量提高率以及治疗过程中的不良反应。结果经三维适形放疗联合唑来膦酸治疗后,联合组完全缓解(CR)17例(48.6%),部分缓解(PR)16例(45.7%),轻度缓解(MR)2例(5.7%),有效率(CR+PR)达94.3%,高于单药组的73.9%(P<0.05)。联合组患者生活质量明显改善,有效率达77.1%,也明显高于单药组的56.5%(P<0.05)。2种治疗方案对患者的不良反应除放疗引起的白细胞减少外,无明显差异。结论三维适形放疗联合唑来膦酸相比较单独应用唑来膦酸治疗可明显缓解转移性骨肿瘤引起的疼痛,减少并发症的发生,提高患者的生活质量。Objective To evaluate the effect of three dimensional conformal radiation therapy（3D-CRT） combined with zoledronic acid for treating bone metastases of malignant tumor. Methods Zoledronic acid （4 mg） with physiological saline （100 ml） were injected once every three to four weeks for three times in 35 elderly patients with bone metastases. DT radiometer （4000 Cgy in 4 weeks） was used on the bone metastases zone according to the reports of MRI. Twenty-three cases treated only with zoledronic acid were chosen as control. Remission rate of pain, the qualities of life and the side effects were evaluated after and before treatment respectively. Results The total effective rate was 94.3% in the patients receiving radiotherapy combined with zoledronic acid, with significant difference compared to patients receiving the simple treatment of zoledronic acid. The qualities of life in the combined group were improved higher than those in the zoledronic acid group. The side effects were reduced leucocytes induced by radiotherapy, which could be reversed by symptomatic therapy. Conclusions 3D-CRT combined with zoledronic acid can relieve the pain and reduce the complications of bone metastases, which is more effective than simple treatment of zoledronic acid.

关 键 词：转移性骨肿瘤 三维适形放疗 唑来膦酸 

分 类 号：R738.1[医药卫生—肿瘤]