唑来膦酸联合放疗与联合化疗治疗非小细胞肺癌骨转移效果观察  

Efficacy analysis of zoledronic acid combined with radiotherapy and combined with chemotherapy for bone metastasis of non-small cell lung cancer

作　　者：邱慧兵[1] 易铁男[1] 张凌云[1] 雷琳[1] 苏敏[1] 

机构地区：[1]湖北文理学院附属襄阳市中心医院肿瘤科,441000

出　　处：《肿瘤研究与临床》2017年第7期437-441,共5页Cancer Research and Clinic

基　　金：国家自然科学基金（2012KFC143）

摘　　要：目的 观察并对比唑来膦酸（ZA）联合放疗与ZA联合化疗治疗非小细胞肺癌（NSCLC）骨转移的临床效果.方法 回顾性分析2010年1月至2014年6月以放疗或化疗为主的综合治疗的78例NSCLC骨转移患者临床资料,其中ZA联合常规放射分割治疗（放疗联合组）39例,ZA联合化疗（紫杉醇脂质体＋顺铂）（化疗联合组）39例,依据世界卫生组织实体瘤客观评价标准、转移癌疗效评价标准、疼痛分级标准、抗癌剂毒性分类分级标准、Karnofsky评分标准,评定并分析患者肺部原发灶及骨转移灶疗效、疼痛改善情况、不良反应发生率、机体功能状态改善情况（治疗前后各1次）等.结果 放疗联合组与化疗联合组的肺部原发灶有效率、骨转移灶有效率、疼痛缓解总有效率、机体功能状态改善率（Karnofsky评分增加10分以上）分别为82.05%（32/39）比79.49%（31/39）、48.72%（19/39）比51.28%（20/39）、82.05%（32/39）比84.62%（33/39）、66.67%（26/39）比71.79%（28/39）,差异均无统计学意义（χ^2值依次为0.224、0.237、0.195、0.259,均P〉0.05）;两组均出现低热、骨髓抑制、放射性食管炎、肝肾损伤、消化道反应等不良反应,不良反应总发生率差异无统计学意义[28.21%（11/39）比30.77%（12/39）,χ^2=0.314,P〉0.05],且对症处理后均得到控制.结论ZA联合放疗或联合化疗均为NSCLC骨转移安全有效的治疗方式,应根据患者病情选择治疗.Objective To observe and compare the curative effects of zoledronic acid （ZA） combined with radiotherapy and ZA combined with chemotherapy in the treatment of bone metastasis of non-small cell lung cancer （NSCLC）. Methods Seventy-eight patients with NSCLC bone metastasis treated by radiotherapy or chemotherapy were taken in our hospital from January 2010 to June 2014, including 39 cases of ZA combined conventional fractionation radiotherapy （radiotherapy combined group）, and 39 cases of ZA combined with chemotherapy （paclitaxel liposome ＋ cisplatin） （chemotherapy combined group）. Each group had 39 cases. WHO objective evaluation standard, efficacy evalulation of solid tumor metastasis and curative effect standard grading of pain, anticancer agent toxicity classification standard, Karnofsky standard were used for evaluating and analyzing the patients with primary lung tumor, bone metastasis, degree of pain, adverse reactions and functional status （once before and after the treatment）. Results The efficiency rate of primary lung tumor, the efficiency rate of bone metastasis, the total effective rate of pain relief and the improvement rate of functional status （Karnofsky score increased by 10 points or more）in the radiotherapy combined group and chemotherapy combined group were 82.05 % （32/39） vs. 79.49 % （31/39）, 48.72 % （19/39） vs. 51.28 %（20/39）, 82.05 % （32/39） vs. 84.62 % （33/39）, 66.67 % （26/39） vs. 71.79 % （28/39） respectively, and the differences were not statistically significant （the values of χ^2 were 0.224, 0.237, 0.195, 0.259 respectively, all P〉 0.05）; Although the two groups showed low-grade fever, bone marrow suppression, esophagitis, liver and kidney damage, gastrointestinal reactions and other adverse reactions, the adverse reactions of two groups were close to [28.21 % （11/39） vs. 30.77 % （12/39）] （χ^2 = 0.314, P〉 0.05）. Fortunately, these reactions were controlled well after symptomatic treatment. Conclusion ZA co

关 键 词：癌 非小细胞肺 放射疗法 计算机辅助 药物疗法 联合 肿瘤转移 唑来膦酸 

分 类 号：R734.2[医药卫生—肿瘤]