目的 评价唑来膦酸联合化疗治疗晚期非小细胞肺癌骨转移的临床疗效及不良反应.方法 回顾性分析使用唑来膦酸联合化疗治疗晚期非小细胞肺癌骨转移48例,唑来膦酸4 mg,每3周1次,化疗每3周为一周期.对治疗前、治疗后1周和6周的有效指标--疼痛评分(NRS)、缓解率、止痛药使用剂量、行为状态评分(KPS)、骨转移灶效果、血清钙浓度、碱性磷酸酶(AKP)进行比较,并分析不良反应事件.结果 治疗1周后疼痛缓解率为75.61%,6周后为82.93%.治疗后1、6周NRS较治疗前显著下降(P＜0.05),KPS则较治疗前显著升高(P＜0.05).治疗后6周血清钙和AKP较治疗前显著下降(P＜0.05).治疗期间出现Ⅰ度或Ⅱ度血液学毒性,2例患者出现新转移灶,无骨相关事件发生.结论 唑来膦酸对骨转移引起的疼痛有良好的止痛效果,迅速降低血钙,具有良好的耐受性,给药方便,能提高患者生活质量.%Objective To evaluate clinical efficacy and side effects of zoledronic acid combined chemotherapy for the treatment of advanced non - small cell lung cancer ( NSCLC ) with bone metastasis. Methods Form January 2008 to June 2010, 48 cases of NSCLC with bone metastasis treated with zoledronic acid combined chemotherapy were retrospectively analyzed. Numeric pain score, relief rate, analgesic dose, performance status score ( KPS ), efficacy on bone metastases, serum calcium, serum alkaline phosphatase ( AKP ), and adverse events were recorded at baseline, 1 and 6 weeks after treatment for analysis. Results The relief rates were 75.61％ and 82.93％ 1 and 6 weeks after treatment, respectively. Significant improvement in pain score and KPS was revealed after treatment ( P ＜ 0. 05 ). 6 weeks after treatmeNt, Significant reduction of serum calcium and AKP were observed 6 weeks after treatment, comparing with those at baseline ( P ＜ 0. 05 ). Degree I or Ⅱ hematological toxicity was reported during treatment. New metastatic lesions were found in 2 patients. No bone - related incident was recorded. Conclusion Zoledronic acid combined with chemotherapy has good analgesic efficacy, with rapid reduction of serum calcium level, good tolerance, convenient administration and improvement of quality of life for advanced non - small cell lung cancer with bone metastasis.
展开▼
