放疗联合唑来膦酸治疗乳腺癌骨转移76例疗效分析
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摘要
目的 :评估放疗联合唑来膦酸治疗乳腺癌骨转移的临床疗效。方法 :选取76例乳腺癌骨转移患者,随机分为A组(放疗联合唑来膦酸组,35例)和B组(单纯放疗组,41例),比较放疗结束及3个月时两组的疗效,并随访1年观察两组的骨相关事件发生率和其它不良反应发生情况。结果 :A组骨痛缓解率明显优于B组;随访1年骨相关事件发生率显著低于B组(P <0.05)。两组不良反应发生率无明显差异(P> 0.05)。结论 :放疗联合唑来膦酸治疗乳腺癌骨转移与单纯放疗相比,疼痛缓解率高,并能显著减少骨相关事件发生率,且不良反应发生率无明显差异。
Objective: To evaluate the clinical efficacy of radiotherapy combined with zoledronic acid in the treatment of breast cancer with bone metastases. Methods: Seventy-six patients with breast cancer and bone metastases were selected and randomly divided into group A(35 cases, treated with radiotherapy combined zoledronic acid) and B(41 cases, treated with radiotherapy alone). The efficacy was compared between the two groups at the end of radiotherapy and 3 months after radiotherapy, and the incidence of bone-related events and the occurrence of adverse reactions in the two groups were observed within one year follow-up. Results: The rate of bone pain relief was significantly better and the incidence of bone-related events was significantly lower in group A than group B(P<0.05). There were no significant differences between the two groups in the incidence of adverse reactions(P>0.05). Conclusion: As compared with radiotherapy alone, the combination of radiotherapy with zoledronic acid for the treatment of breast cancer with bone metastases has higher rate of pain relief and lower incidence of adverse reactions without significant differences in adverse reactions.
Objective: To evaluate the clinical efficacy of radiotherapy combined with zoledronic acid in the treatment of breast cancer with bone metastases. Methods: Seventy-six patients with breast cancer and bone metastases were selected and randomly divided into group A(35 cases, treated with radiotherapy combined zoledronic acid) and B(41 cases, treated with radiotherapy alone). The efficacy was compared between the two groups at the end of radiotherapy and 3 months after radiotherapy, and the incidence of bone-related events and the occurrence of adverse reactions in the two groups were observed within one year follow-up. Results: The rate of bone pain relief was significantly better and the incidence of bone-related events was significantly lower in group A than group B(P<0.05). There were no significant differences between the two groups in the incidence of adverse reactions(P>0.05). Conclusion: As compared with radiotherapy alone, the combination of radiotherapy with zoledronic acid for the treatment of breast cancer with bone metastases has higher rate of pain relief and lower incidence of adverse reactions without significant differences in adverse reactions.
引文
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[2]杨柯君.全球癌症状况最新数据更新[J].上海医药,2014,35(2):5.
[3]贺丹,付波,王敏.乳腺癌骨转移患者放疗后的预后分析[J].中国肿瘤临床与康复,2017,24(4):436-439.
[4]汤恩彪,阚秀英,严伟民.乳腺癌临床用药概述[J].上海医药,2006,27(8):363-364.
[5]唐青,周九三.唑来膦酸、帕米膦酸二钠联合放射治疗肺癌、乳腺癌骨转移疗效观察[J].临床合理用药,2015,8(2A):77-78.
[6]殷蔚伯,谷铣之.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2004:1089-1090.
[7]Ferretti G,Fabi A,Carlini P,et al.Zoledronic-acid-induced circulating level modifications of angiogenic factors,metalloproteinases and proinflammatory cytokines in metastatic breast cancer patients[J].Oncology,2005,69(1):35-43.
[8]Neville-Webbe HL,Coleman RE,Holen I.Combined effects of the bisphosphonate,zoledronic acid and the aromatase inhibitor letrozole on breast cancer cells in vitro:evidence of synergistic interaction[J].Br J Cancer,2010,102(6):1010-1017.
[9]Tamura T.Zoledronic acid,a third-generation bisphosphonate,inhibits cellular growth and induces apoptosis in oral carcinoma cell lines[J].Oncol Rep,2011,25(4):1139-1143.
[10]Hattori Y.Zoledronic acid enhances antitumor efficacy of liposomal doxorubicin[J].Int J Oncol,2015,47(1):211-219.
[11]Ottewell PD.Sustained inhibition of tumor growth and prolonged survival following sequential administration of doxorubicin and zoledronic acid in a breast cancer model[J].Int J Cancer,2010,126(2):522-532.
[12]马建华,郭嘉漪.三维适形放疗联合双膦酸盐治疗骨转移癌的临床观察[J].山西医科大学学报,2013,44(9):727-728.
[13]陈玲,杜丽娟,潘荣强.不同剂量放疗联合唑来膦酸治疗癌性骨转移痛的效果比较[J].广东医学,2014,35(17):2759-2760.
[14]高丽萍,贾小林,程俊,等.不同分割剂量放疗联合唑来膦酸治疗老年骨转移癌的疗效[J].中国老年学,2015,35(15):4272-4274.
[15]Body JJ,Diel IJ,Lichinitzer M,et al.Oral ibandronate reduces the risk of skeletal complications in breast cancer patients with metastatic bone disease:results from two randomised,placebo‐controlled phase III studies[J].Br JCancer 2004,90(6):1133‐1137.