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目的探讨唑来膦酸联合放疗治疗骨转移临床疗效、不良反应。方法收集2009年3月至2010年2月安阳市肿瘤医院放疗科收治的148例恶性肿瘤骨转移病例进行回顾性分析。综合组:放射治疗+唑来膦酸注射液治疗80例;单放组:单纯行姑息性放射治疗68例。两组放疗均采用6mV-X线大分割体外照射,3GY/次,5次/周,总DT30GY;综合组药物治疗为唑来膦酸注射液4mg+0.9%NaCl100ml静脉滴注,15min输完。结果综合组和单放组的疼痛缓解率分别是92.5%,91.2%,比较差异无统计学意义(P>0.05);两组不良反应发生比较无明显差异;骨转移灶再钙化有效率分别是68.8%,41.2%比较差异有统计学意义(P<0.05);疼痛缓解期:综合组6～20个月,单放组3～12个月。结论唑来膦酸联合放疗治疗骨转移疗效明显,骨质修复、疼痛缓解期及患者生活质量均优于单纯放射治疗,并未见明显不良反应,是目前恶性肿瘤骨转移的常规治疗手段。
Objective To investigate the clinical efficacy and adverse reactions of zoledronic acid combined with radiotherapy in the treatment of bone metastases. Methods A total of 148 cases of malignant bone metastases from March 2009 to February 2010 in Anyang Cancer Hospital were retrospectively analyzed. Comprehensive group: radiotherapy + zoledronic acid injection in 80 cases; single group: palliative radiotherapy alone in 68 cases. Radiotherapy was performed in both groups using 6mV-X ray in vitro, 3GY / time, 5 times / week, and total DT30GY. The combination therapy was intravenous infusion of zoledronic acid injection 4mg + 0.9% NaCl100ml and the infusion was completed in 15min. Results The pain relief rates of the combined group and the single group were 92.5% and 91.2% respectively, with no significant difference (P> 0.05). There was no significant difference between the two groups in the incidence of adverse reactions; the rates of recalcification of bone metastases were 68.8% and 41.2%, respectively (P <0.05). The pain relief period was 6 to 20 months in the combination group and 3 to 12 months in the single group. Conclusion Zoledronic acid combined with radiotherapy is effective in treatment of bone metastases. Osteoporosis, pain relief and quality of life of patients are superior to radiotherapy alone, and no obvious adverse reactions have been found. It is a common treatment for bone metastases of malignant tumors.