张青菊, 徐文贵, 戴东, 宋秀宇. 89Sr联合唑来膦酸治疗骨转移瘤骨痛的安全性及疗效评价[J]. 中国肿瘤临床, 2015, 42(23): 1138-1142. DOI: 10.3969/j.issn.1000-8179.2015.23.113
引用本文: 张青菊, 徐文贵, 戴东, 宋秀宇. 89Sr联合唑来膦酸治疗骨转移瘤骨痛的安全性及疗效评价[J]. 中国肿瘤临床, 2015, 42(23): 1138-1142. DOI: 10.3969/j.issn.1000-8179.2015.23.113
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Qingju ZHANG, Wengui XU, Dong DAI, Xiuyu SONG. Safety and efficiency evaluation of the combined therapy of 89Sr plus zoledronic acid in patients with painful bone metastases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(23): 1138-1142. DOI: 10.3969/j.issn.1000-8179.2015.23.113
Citation: Qingju ZHANG, Wengui XU, Dong DAI, Xiuyu SONG. Safety and efficiency evaluation of the combined therapy of 89Sr plus zoledronic acid in patients with painful bone metastases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(23): 1138-1142. DOI: 10.3969/j.issn.1000-8179.2015.23.113
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89Sr联合唑来膦酸治疗骨转移瘤骨痛的安全性及疗效评价

Safety and efficiency evaluation of the combined therapy of 89Sr plus zoledronic acid in patients with painful bone metastases

    摘要
  • 摘要: 目的：评价89Sr 及89Sr 联合唑来膦酸治疗骨转移瘤骨痛的安全性及疗效。方法：回顾性分析确诊为恶性肿瘤骨转移患者87例，分为89Sr 治疗组53例，89Sr 联合唑来膦酸34例（其中4 例未入组、再分为89Sr 治疗优先组17例、唑来膦酸优先组13例）；89Sr联合唑来膦酸亚组分组标准为89Sr 治疗后2～14天行唑来膦酸治疗，或唑来膦酸治疗后4～7 天行89Sr 治疗。通过χ2检验、连续校正χ2检验或Fisher 精确概率检验方法比较不同治疗方法止痛有效率及KPS 变化。通过独立样本Kruskal-Wallis检验比较不同原发肿瘤行89Sr 及89Sr 联合唑来膦酸治疗后止痛有效率及KPS 变化。结果：全部病例均未出现较严重不良反应。89Sr 及89Sr 联合唑来膦酸治疗后，患者均表现疼痛评分减低，KPS 评分提高，其中以89Sr 联合唑来膦酸治疗疼痛评分及KPS 评分变化更明显，差异有统计学意义（P = 0.047；P = 0.036）。 比较唑来膦酸治疗优先组与89Sr 治疗优先组止痛有效率和KPS 提高率（P = 1.000 和P = 0.667），差异无统计学意义。不同原发肿瘤89Sr 治疗（P = 0.837 和P = 0.074）及89Sr 联合唑来膦酸治疗（P = 0.321 和P = 0.118）后骨痛及KPS 评分变化比较未见明显差异。结论：89Sr 及89Sr 联合唑来膦酸治疗骨转移瘤均有较好疗效，其中，两者联合治疗较89Sr 治疗安全性无差异，但疗效更佳。

     

    Abstract: Objective:To evaluate and compare the safety and efficiency of the combined therapy of 89Sr plus zoledronic acid and those of 89Sr-chloride alone, in patients with painful bone metastases. Methods:A total of 87patients with osseous metastasis were ran -domly divided into treatment groups of 89Sr-chloride alone (group A,53patients) and 89Sr plus zoledronic acid (group B, 34patients). A total of 17patients in group B received zoledronic acid 2- 14days after 89Sr therapy, and13other patients in the group received89Sr 4-7 days after zoledronic-acid therapy. Pain response and KPS score were evaluated after the different treatments.Results: No obvious bone marrow suppression and liver damage were found in all cases. All patients who received both 89Sr-chloride and 89Sr plus zoledronic acid showed reduced bone pain and total discomfort, as well as improved KPS score, but the response was more pronounced in group B (P=0.047; P=0.036). No statistical differences in pain score and KPS scores were observed between the groups treated with zoledronic acid first and 89Sr therapy first ( P=1.000; P=0.667). Comparison of bone pain relief and changes in the KPS score of different primary tumors after treatment with 89Sr- chloride or 89Sr plus zoledronic acid showed no statistical significance. Conclusion:Compared with 89 Sr-chloride, treatment with 89 Sr plus zoledronic acid was more effective in patients with painful bone metastases. The safety of these two treatments are similar.

     

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