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目的探讨放疗联合唑来膦酸与单纯放疗治疗非小细胞肺癌(NSCLC)骨转移的短期疗效及其影响因素。方法选择2009~2013年在该院肿瘤中心接受骨病变放疗的NSCLC骨转移患者117例(153个病灶),采用放疗联合唑来膦酸(联合治疗组,n=54)与单纯放疗治疗(单纯放疗组,n=63),对病灶骨痛缓解及其影响因素进行分析。结果单纯放疗组与联合治疗组的有效率分别为69.74%和92.21%(χ2=13.75,P<0.01),多因素Logistic回归分析表明患者的骨痛缓解与治疗方式相关,且联合治疗组的骨痛缓解率高于单纯放疗组(OR=4.60,95%CI:1.23~17.20,P=0.02)。在治疗方式的亚组多因素分析中,溶骨性病灶患者(OR=26.59,95%CI:3.29~215.12,P=0.00)具有较好的疗效,在无骨相关事件方面,联合治疗组更具优势(OR=4.40,95%CI:1.49~12.99,P=0.01)。结论放疗联合唑来膦酸相对于单纯放疗治疗NSCLC骨转移具有更好的疗效。
Objective To investigate the short-term effects of radiotherapy combined with zoledronic acid and radiotherapy on non-small cell lung cancer (NSCLC) bone metastasis and its influencing factors. Methods A total of 117 patients (153 lesions) with NSCLC who underwent radiotherapy for bone lesion at the Cancer Center of the Hospital from 2009 to 2013 were treated with radiotherapy combined with zoledronic acid (combination therapy group, n = 54) and radiotherapy alone Radiotherapy group, n = 63). The relief of focal bone pain and its influencing factors were analyzed. Results The effective rates of the radiotherapy alone group and the combination therapy group were 69.74% and 92.21%, respectively (χ2 = 13.75, P <0.01). Multivariate Logistic regression analysis showed that the relief of pain was associated with the treatment modality, The pain relief rate was higher than that of radiotherapy alone (OR = 4.60, 95% CI: 1.23-17.20, P = 0.02). In the subgroup multivariate analysis of treatment modalities, patients with osteolytic lesions (OR = 26.59, 95% CI: 3.29 to 215.12, P = 0.00) had better efficacy. In the no bone related event, the combination therapy group There was an advantage (OR = 4.40, 95% CI: 1.49-12.99, P = 0.01). Conclusion Radiotherapy combined with zoledronic acid has a better therapeutic effect on bone metastasis of NSCLC than radiotherapy alone.