局部放疗联合注射用因卡膦酸二钠对原发性肝癌骨转移患者的疗效和安全性分析  

Efficacy and safety of local radiotherapy combined with incadronate disodium for injection in patients with bone metastasis of primary liver cancer

作　　者：陈音 邹庆芳 邵宏斌 张琦 崔鹤滕 齐晓晖 张勇 Chen Yin;Zou Qingfang;Shao Hongbin;Zhang Qi;Cui Heteng;Qi Xiaohui;Zhang Yong(Department of the First Clinic,the 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China;Department of Sports Medicine,the 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China;the First Clinical Medicine College of Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Clinical Laboratory,the 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China;Department of Oncology,the 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China)

机构地区：[1]中国人民解放军联勤保障部队第九四〇医院第一派驻门诊部,兰州730050 [2]中国人民解放军联勤保障部队第九四〇医院运动医学科,兰州730050 [3]甘肃中医药大学第一临床医学院,兰州730000 [4]中国人民解放军联勤保障部队第九四〇医院检验科,兰州730050 [5]中国人民解放军联勤保障部队第九四〇医院肿瘤科,兰州730050

出　　处：《肿瘤综合治疗电子杂志》2022年第4期45-50,共6页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：全军后勤科研项目(CLB21J035);中央高校科研基金重大需求培育资助项目(31920220108);联勤保障部队第九四〇医院军队科研项目(2021yxky020)。

摘　　要：目的探讨局部放疗联合注射用因卡膦酸二钠对原发性肝癌骨转移患者的疗效和安全性。方法选取2019年1月至2022年1月中国人民解放军联勤保障部队第九四〇医院收治的90例原发性肝癌骨转移患者为研究对象,采用随机数字表法将患者分为对照组(局部放疗)、唑来膦酸组(局部放疗联合唑来膦酸)、因卡膦酸二钠组(局部放疗联合因卡膦酸二钠),每组各30例。比较三组患者的临床疗效和安全性。结果三组患者治疗后视觉模拟评分法(visual analogue scale,VAS)评分、血总胆红素(total bilirubin,TBIL)、谷丙转氨酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、骨碱性磷酸酶(bone alkaline phosphatase,BAP)、Ⅰ型胶原交联氨基末端肽(N-telopeptide of typeⅠcollagen,NTX)水平均显著低于本组治疗前(均P<0.05),改良Barthel指数(modified Barthel index,MBI)评分、骨密度(bone mineral density,BMD)均显著高于本组治疗前(均P<0.05)。对照组患者治疗后VAS评分、血TB、GPT、ALP、BAP、NTX水平均显著高于同期另外两组(均P<0.05),MBI评分、BMD均显著低于同期另外两组(均P<0.05),而唑来膦酸组与因卡膦酸二钠组患者治疗后上述指标比较差异均无统计学意义(均P>0.05)。三组患者不良反应均较轻微,以发热最为常见,予观察或对症处理后均缓解,唑来膦酸组患者不良反应总发生率显著高于另外两组(均P<0.05),而对照组与因卡膦酸二钠组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论局部放疗联合注射用因卡膦酸二钠能明显缓解原发性肝癌骨转移患者的骨痛,提高患者生活自理能力和BMD,改善肝功能与骨代谢水平,且安全性较高,优于局部放疗联合唑来膦酸。Objective To investigate the efficacy and safety of local radiotherapy combined with incadronate disodium for injection in patients with bone metastasis of primary liver cancer.Method Ninety patients with bone metastasis of primary liver cancer treated in the 940Hospital of Joint Logistics Support Force of People’s Liberation Army from January 2019 to January 2022 were enrolled for the research and randomly divided into control group(local radiotherapy),zoledronic acid group(local radiotherapy combined with zoledronic acid)and incadronate disodium group(local radiotherapy combined with incadronate disodium),with 30 cases in each group.The clinical efficacy and safety among the three groups were compared.Result The visual analogue scale(VAS)score,the blood levels of total bilirubin(TBIL),alanine aminotransferase(ALT),alkaline phosphatase(ALP),bone alkaline phosphatase(BAP)and N-telopeptide of typeⅠcollagen(NTX)after treatment in the three groups were significantly lower than those before treatment(all P<0.05),and the score of modified Barthel index(MBI)and bone mineral density(BMD)were significantly higher than those before treatment(all P<0.05).The VAS score,blood levels of TBIL,ALT,ALP,BAP and NTX after treatment in control group were significantly higher than those in the other two groups in the same period(all P<0.05),and the MBI score and BMD were significantly lower than those in the other two groups in the same period(all P<0.05),while there were no significant differences in the above indexes between zoledronic acid group and incadronate disodium group(all P>0.05).The adverse reactions of the three groups were mild,and fever was the most common,which was relieved after observation or symptomatic treatment.The total incidence of adverse reaction in zoledronic acid group was significantly higher than that in the other two groups(all P<0.05),while there was no significant difference in the total incidence of adverse reaction between control group and incadronate disodium group(P>0.05).Conclusion The clini

关 键 词：因卡膦酸二钠 原发性肝癌 骨转移 唑来膦酸 放疗 疗效 安全性 

分 类 号：R735.7[医药卫生—肿瘤]