应用唑来膦酸预防实体瘤骨相关事件的疗效及生存研究  

Study on the Efficacy and Survival of Zoledronic Acid in Preventing Skeletal Related Events in Solid Tumors

作　　者：张克斌 杜杰 彭英 ZHANG Ke-bin;DU Jie;PENG Ying(Department of Oncology,General Hospital of Shuikuang Holding Group Co.,Ltd.,Liupanshui 553001,Guizhou,China)

机构地区：[1]水矿控股集团有限责任公司总医院肿瘤科,贵州六盘水553001

出　　处：《医学信息》2024年第1期109-114,共6页Journal of Medical Information

基　　金：贵州省六盘水市科技局2019年社会攻关项目(编号:52020-2019-0-1-14)。

摘　　要：目的探讨应用唑来膦酸(ZOL)前瞻性早期干预实体瘤骨转移、骨相关事件(SREs)的疗效,及对无骨转移、无SREs生存期(TTPS)、总生存期(OS)的影响。方法选择2016年1月-2020年12月165例在本院治疗结束的患者,按照随机1∶2法分为观察组55例,为治疗结束即使用ZOL预防骨转移的患者,对照组110例为同期治疗结束的、不使用ZOL、定期随访的患者。观察两组骨转移及及SREs发生的比率及与生存的关系。结果观察组骨转移3例(5.45%)、SREs2例(3.64%),分别低于对照组的26例(23.85%)、19例(17.43%),差异有统计学意义(P<0.05)。两组OS和中位无进展生存期(MST)经Log-rank法比较无差异。观察组1~5年的TTPS和中位无骨转移生存期(MPST)分别为87%、62%、31%、13%、0和29.0个月(95%CI:25.371~32.629),与对照组的78%、55%、27%、2%、0和26.0个月(95%CI:21.717~30.283)比较,差异有统计学意义(x^(2)=4.155,P=0.040)。结论尚未发生骨转移的实体瘤患者,在抗肿瘤专科治疗结束后,早期使用ZOL预防治疗,能使骨转移、SREs减少,TTPS延长。应用ZOL预防实体瘤骨转移、SREs有效,对无进展生存有益。Objective To investigate the efficacy of zoledronic acid(ZOL)for a prospective early intervention in solid tumor bone metastasis,skeletal related events(SREs),and the effects on non-metastatic,non-SREs time to progress survival(TTPS),and overall survival(OS).Methods A total of 165 patients who were enrolled in our hospital from January 2016 to December 2020 were randomly divided into observation group(55 patients)and control group(110 patients)by 1:2 method.The patients in the observation group were treated with ZOL to prevent bone metastasis at the end of treatment,while the patients in the control group were treated without ZOL and followed up regularly at the end of the same period.The incidence of bone metastasis and SREs in the two groups and their relationship with survival were observed.Results There were 3 cases(5.45%)of bone metastasis and 2 cases(3.64%)of SREs in the observation group,which were lower than 26 cases(23.85%)and 19 cases(17.43%)in the control group,the differences were statistically significant(P<0.05).There was no difference in OS and median survival time(MST)between the two groups by Log-rank method.The 1-5-year TTPS and median progress survival tim(MPST)were 87%,62%,31%,13%,0 and 29.0 months(95%CI:25.371-32.629)in the observation group,and 78%,55%,27%,2%,0 and 26.0 months(95%CI:21.717-30.283)in the control group,the difference was statistically significant(?x^(2)=4.155,P=0.040).Conclusion For patients with solid tumors that have not yet developed bone metastases,early use of ZOL prophylaxis after the end of anti-tumor specialist treatment can reduce the incidence of bone metastases and SREs,and prolong TTPS.Therefore,the application of ZOL to prevent solid tumor bone metastasis and SREs is effective and beneficial to progression-free survival.

关 键 词：实体瘤 骨转移 唑来膦酸 骨相关事件 无SREs生存期 

分 类 号：R738.1[医药卫生—肿瘤]