两种不同放疗方式联合唑来膦酸治疗肺癌骨转移的效果及对疼痛的影响  

Effect of two different radiotherapy modes combined with zoledronic acid on bone metastases from lung cancer and its influence on pain

作　　者：赵小顺[1] 陈红利[1] 李奎[1] 李晓宇 Zhao Xiaoshun;Chen Hongli;Li Kui;Li Xiaoyu(Department of Pharmacy,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院药学部,新乡453000

出　　处：《中国实用医刊》2022年第19期49-53,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨立体定向放疗(SBRT)和常规分割放疗(CFRT)分别联合唑来膦酸治疗肺癌骨转移的效果及对疼痛的影响。方法抽取2017年10月至2021年10月新乡市中心医院收治的肺癌骨转移患者125例,按照放疗方式将其分为SBRT组(63例,SBRT联合唑来膦酸治疗)与CFRT组(62例,CFRT联合唑来膦酸治疗)。观察两组疼痛控制效果,测定治疗前后血清癌胚抗原(CEA)、糖类抗原125(CA125)、白细胞介素-6(IL-6)、骨碱性磷酸酶(BAP)水平及卡氏功能(KPS)评分,比较两组的不良反应发生率。结果SBRT组疼痛控制总有效率为87.30%(55/63),高于CFRT组的72.58%(45/62),差异有统计学意义(P<0.05)。治疗后,两组血清CEA、CA125、IL-6、BAP水平均低于治疗前(P均<0.05),且SBRT组低于CFRT组(t=3.49、3.08、2.10、6.49,P均<0.05)。治疗后,两组KPS评分均高于治疗前(P均<0.05),且SBRT组高于CFRT组(t=2.27,P<0.05)。SBRT组恶心呕吐及骨髓抑制的发生率低于CFRT组(Z=4.47、4.59,P均<0.05)。结论SBRT与CFRT联合唑来膦酸治疗肺癌骨转移的近期效果相似,但SBRT治疗后患者疼痛症状和血清CEA、CA125、IL6、BAP水平及KPS评分的改善程度更佳,不良反应更少。Objective To investigate the clinical efficacy of stereotactic body radiation therapy(SBRT)and conventional fractionated radiation therapy(CFRT)in combination with zoledronic acid on bone metastases from lung cancer and its influence on pain.Methods A total of 125 patients with bone metastases from lung cancer admitted to Xinxiang Central Hospital from October 2017 to October 2021 were selected.According to the radiotherapy methods,the patients were divided into SBRT group(63 cases,treated by SBRT combined with zoledronic acid)and CFRT group(62 cases,treated by CFRT combined with zoledronic acid).The pain control effect of the two groups were observed,and the levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),interleukin-6(IL-6),bone alkaline phosphatase(BAP)and karnofsky performance status(KPS)score before and after treatment were measured,and the incidence of adverse reactions of the two groups were compared.Results The total effective rate of pain control in the SBRT group was 87.30%(55/63),higher than 72.58%(45/62)in the CFRT group(P<0.05).After treatment,the serum levels of CEA,CA125,IL-6 and BAP in the two groups were lower than those before treatment(allP<0.05),and these indexes in the SBRT group were lower than those in the CFRT group(t=3.49,3.08,2.10,6.49;all P<0.05).After treatment,the KPS score in the two groups were higher than those before treatment(allP<0.05),and the scores in the SBRT group were higher than those in the CFRT group(t=2.27,P<0.05).The incidences of nausea,vomiting and bone marrow suppression in the SBRT group were lower than those in the CFRT group(Z=4.47,4.59;all P<0.05).Conclusions The short-term effects of SBRT and CFRT in the combination treatment with zoledronic acid on bone metastases from lung cancer are similar;however,the pain symptoms,serum levels of CEA,CA125,IL-6 and BAP,and KPS scores after SBRT treatment are better improved,with fewer adverse reactions.

关 键 词：肺癌 骨转移 立体定向放疗 常规分割放疗 唑来膦酸 

分 类 号：R734.2[医药卫生—肿瘤]