放疗联合唑来膦酸治疗NSCLC骨转移的疗效分析及影响因素  

Effect analysis on radiotherapy combined with zoledronic acid in treatment of bone metastasis of non-small cell lung cancer and influencing factors

作　　者：李建[1] 王阁[1] 肖何[1] 金丰[1] 余娴[1] 毛必静[1] 何容[1] 蒋梅[1] 杨镇洲[1] 王东[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肿瘤中心,重庆400042

出　　处：《重庆医学》2015年第12期1629-1632,共4页Chongqing medicine

基　　金：吴阶平基金资助项目(320.6750.12228;320.6750.12177)

摘　　要：目的探讨放疗联合唑来膦酸与单纯放疗治疗非小细胞肺癌（NSCLC）骨转移的短期疗效及其影响因素。方法选择2009～2013年在该院肿瘤中心接受骨病变放疗的NSCLC骨转移患者117例（153个病灶），采用放疗联合唑来膦酸（联合治疗组,n=54）与单纯放疗治疗（单纯放疗组，n=63），对病灶骨痛缓解及其影响因素进行分析。结果单纯放疗组与联合治疗组的有效率分别为69．74％和92．21％（X^2=13．75，P〈o．01），多因素Logistic回归分析表明患者的骨痛缓解与治疗方式相关，且联合治疗组的骨痛缓解率高于单纯放疗组（OR=4．60，95％CI：1．23～17．20，P=0．02）。在治疗方式的亚组多因素分析中，溶骨性病灶患者（0R=26．59，95％CI：3．29～215．12，P=0．00）具有较好的疗效，在无骨相关事件方面，联合治疗组更具优势（OR=4．40，95％CI：1．49～12．99，P一0．01）。结论放疗联合唑来膦酸相对于单纯放疗治疗NSCLC骨转移具有更好的疗效。Objective To investigate the short-term efficacy and the influencing factors of zoledronic acid combined with ra- diotherapy and single radiotherapy in the treatment of bone metastasis in non-small cell lung cancer（NSCLC）. Methods Totally 117 NSCLC patients with bone metastases（153 lesions） receiving the bone lesion radiotherapy in the Tumor Center of our hospital from 2009 to 2013 were selected and treated by zoledronic acid combined with radiotherapy（combined therapy group, n= 54） and the single radiotherapy （single radiotherapy group,n=63）. The bone pain relief and influence factors were analyzed. Results The effective rates in the single radiotherapy group and the combined radiotherapy group were 69.74% and 92.21% respectively（X^2 = 13.75,P〈0.01） ;the multivariate Logistic regression analysis showed that the bone pain relief was correlated with the treatment mode,moreover the bone pain relief rate in the combined therapy group was significantly higher than that in the single therapy group （OR=4. 60,95 %CI： 1.23--17.20, P= 0.02）. In the subgroup analysis of treatment modes, the patients with osteolytic le- sions（OR = 26.59,95 %CI： 3.29--215.12, P= 0.00） had better effect. The combined therapy group had more superiority in the as- pect of non-skeletal related events occurrence （OR = 4.40,95 %CI： 1.49- 12.99, P= 0.01）. Conclusion Radiotherapy combined with zoledronic acid has better curative effect compared with single radiotherapy in the NSCLC patients with bone metastasis.

关 键 词：癌 非小细胞肺癌 骨 肿瘤转移 唑来膦酸 放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]