锶89与放疗在非小细胞肺癌骨转移骨痛治疗中的疗效比较

摘要

Objective To compare the curative effects and adverse effects of strontium 89 and radiotherapy in the treatment of bone metastasis and ostealgia induced by non-small cell lung cancer and to provide guidance for clinical application. Methods 50 patients with non-small cell lung cancer who were admitted to our hospital from August 2011 to August 2013 were selected. All patients were confirmed to have bone metastasis via pathology and bone imaging of MRI.They were randomLy assigned into two groups.Group one received strontium 89 combined with zoledronic acid,and group two received radiotherapy combined with zoledronic acid. Dynamic changes of ostealgia,results of blood routine tests,hepatic and renal functions and lesions by bone scanning in patients were monitored. Results The conditions of ostealgia and lesion regression in the group of strontium 89 combined with zoledronic acid were significantly better than those in the group of radiotherapy combined with zoledronic acid (P<0.05).Three patients in the group of strontium 89 combined with zoledronic acid were detected to have low counts of white blood cells and platelets,and recovered in three days by blood enrichment;12 patients in the group of radiotherapy combined with zoledronic acid were detected to have low counts of white blood cells and platelets,and Seven of them recovered in three days; no hepatic and renal injuries were found in neither groups. Conclusion 89Sr combined with zoledronic acid in the treatment of bone metastasis and ostealgia induced by non-small cell lung cancer significantly improves curative effects compared to radiotherapy,and shows slight bone marrow suppression,which is worthy of clinical application.%目的：比较锶89与放疗在非小细胞肺癌骨转移骨痛治疗中的疗效及不良反应，指导临床应用。方法选取我院2011年8月～2013年8月期间收治的非小细胞肺癌骨转移患者50例，所有患者均经病理证实，磁共振骨显像明确骨转移。随机分为两组，1组选择锶89联合唑来膦酸治疗，2组选择放疗联合唑来膦酸治疗，监测患者骨痛动态变化、血常规、肝肾功及骨扫描病灶变化。结果锶89联合唑来膦酸组骨痛反应情况及病灶消退情况明显优于放疗联合唑来膦酸组（P＜0.05）。锶89联合唑来膦酸组患者出现白细胞及血小板降低者3例，经升血治疗后3d后恢复；放疗联合唑来膦酸组白细胞及血小板降低者12例，7例患者3d后恢复；锶89联合唑来膦酸组及放疗联合唑来膦酸组均未发现肝肾功能损伤。结论氯化锶（89 Sr）联合唑来膦酸辅助治疗非小细胞肺癌骨转移骨痛,相较于放疗能显著提高治疗效果，且骨髓抑制较轻，值得临床应用。