阿那曲唑联合伊班膦酸钠治疗绝经后乳腺癌骨转移的效果观察  

Clinical effect of anastrozole combined with ibandronate on postmenopausal breast cancer with bone metastasis

作　　者：王如良[1] 张少华 李光辉[1] 赵慧霞[1] 彭秀梅[1] 肖文华[1] 

机构地区：[1]解放军总医院第一附属医院肿瘤一科,北京100048 [2]解放军第三0七医院乳腺肿瘤内科,北京100071

出　　处：《中国医药》2017年第6期905-908,共4页China Medicine

摘　　要：目的观察阿那曲唑联合伊班膦酸钠治疗绝经后乳腺癌骨转移的临床效果。方法回顾性分析2012年6月至2013年8月解放军总医院第一附属医院收治的绝经后乳腺癌骨转移106例女性患者的临床资料。根据用药方法的不同，将患者分为对照组和治疗组，各53例。对照组给予口服阿那曲唑1mg，每日1次，至肿瘤进展。治疗组在此基础上，联合静脉滴注伊班膦酸钠治疗，将4mg伊班膦酸钠与500ml不含钙离子的0．9％氯化钠注射液混合稀释后，静脉持续滴注2h以上，1次／4周，持续应用至出现新的骨相关事件。治疗组患者中位治疗时间11个月；对照组患者中位治疗时间10个月。比较2组患者治疗前后的骨痛疼痛数字评分法（NRS）评分和Kamofsky评分，治疗后随访1、2、3年的生存率，治疗后骨转移病灶的治疗总有效率，以及发热、寒战、肌肉和骨酸痛等不良反应发生情况。结果治疗后，治疗组患者骨痛NRS评分明显低于对照组[（1．4±0．8）分比（2．5±1．2）分]，Kamofsky评分明显高于对照组[（81±7）分比（72±7）分]，差异均有统计学意义（均P〈0．05）；治疗组患者的1、2、3年的生存率均明显高于对照组[90．6％（48／53）比79．2％（42／53）、77．4％（41／53）比50．9％（27／53）、49．1％（26／53）比20．8％（11／53）]，差异均有统计学意义（均P〈0．05）；治疗组患者骨转移病灶的治疗总有效率明显高于对照组[86．8％（46／53）比69．8％（37／53）]，差异有统计学意义（P〈0．05）；治疗组和对照组不良反应发生率比较[9．4％（5／53）比17．0％（9／53）]，差异无统计学意义（P〉0．05）。结论阿那曲唑联合伊班膦酸钠治疗绝经后乳腺癌骨转移患者的临床疗效明显，可有效减轻骨痛，促进骨转移病灶的修复，同时能延长患者的生存期，且不良反应较少。Objective To observe the clinical effect of anastrozole combined with ibandronate on postm- enopausal breast cancer with bone metastasis. Methods Totally 106 postmenopansal breast cancer patients with bone metastasis from June 2012 to August 2013 in First Affiliated Hospital of PLA General Hospital were retrospec- tively analyzed; patients who were treated with anastrozole （1 rag/time, 1 time/d） were allocated to control group; patients with anastrozole and ibandronate （4 mg ibandronate mixed with 0. 9% sodium chloride solution, intrave- nous drip, once 4 weeks） were allocated to observation group, with 53 cases in each group. The median time of therapy was 11 months in observation and 10 months in control group. Scores of Numerical Rating Scale（NRS） for ostealgia and Karnofsky Scale were recorded before and after therapy ; 1,2, 3 year survival rates and total effective rate of bone metastasis were analyzed; occurrences of adverse reactions （ fever, shiver, myalgia, ostalgia ） were observed. Results After treatment, the NItS score in observation group was significantly lower and the Karnofsky score was significantly higher than those in control group [ （ 1.4 ± 0. 8 ） scores vs （ 2. 5±1.2 ） scores, （ 81± 7 ） scores vs （ 72 ± 7 ） scores ] （ P 〈 0. 05 ） ; 1,2, 3 year survival rate sin observation group were significantly higher than those in control group[90. 6% （48/53） vs 79. 2% （42/53）, 77.4% （41/53） vs 50. 9% （27/53）, 49. 1% （26/53） vs 20. 8% （11/53）] （P 〈 O. 05 ）. The total effective rate of bone metastasis in observation group was significantly higher than that in control group [ 86. 8% （46/53） vs 69. 8% （37/53） ] （P 〈 O. 05 ）. The incidence of adverse reactions had no significant difference between groups [ 9.4% （ 5/53 ） vs 17.0% （ 9/53 ） ] （ P 〉 0. 05 ）.Conclusion Anastrozole combined with ibandronate treating postmenopausal breast cancer is safe and effective in alleviating ostalgia, promoting bone reparation

关 键 词：乳腺肿瘤 伊班膦酸钠 阿那曲唑 骨转移 

分 类 号：R737.9[医药卫生—肿瘤]