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目的探讨唑来膦酸联合NP化疗治疗乳腺癌骨转移的效果,为临床用药提供依据。方法选取2012年12月至2014年5月收治的经蒽环类及紫衫类药物治疗失败的乳腺癌骨转移患者104例为研究对象,采用随机数字表法分为观察组和对照组,每组52例,对照组采用NP化疗方案(长春瑞滨+顺铂),观察组在此基础上给予唑来膦酸,均治疗2个月,比较两组血清癌胚抗原(CEA)、骨转化生化标志物Ⅰ型前胶原氨基端延长肽(TPINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、转化生长因子-β2(TGF-β2)、甲状旁腺相关蛋白(PTH-r P),同时分析两组2年内治疗有效率及不良反应发生率。结果治疗后2个月观察组CEA[(1.70±0.30)μg/L]、TPINP[(25.30±3.20)μg/L]、β-CTx[(0.20±0.10)pg/L]、TGF-β2[(0.10±0.10)g/L]、PTH-r P[(43.20±1.80)ng/L]均显著低于对照组(P<0.05);2年内观察组治疗有效率(84.6%)与对照组(67.3%)比较差异有统计学意义(P<0.05);两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论唑来膦酸联合NP化疗可有效降低乳腺癌患者骨转移,且不良反应发生率低,值得在临床广泛应用。
Objective To investigate the effect of zoledronic acid combined with NP chemotherapy in the treatment of bone metastasis of breast cancer and provide basis for clinical medication. Methods A total of 104 patients with breast cancer who had failed to receive anthracycline and topiramate treatment between December 2012 and May 2014 were enrolled in this study. Patients were divided into observation group and control group by random number table (N = 52). The control group received NP chemotherapy (vinorelbine + cisplatin). On the basis of this, the observation group was given zoledronic acid and both were treated for 2 months. The serum levels of carcinoembryonic antigen (CEA), bone turnover The biochemical markers TPINP, β-CTx, TGF-β2, PTH-r P). At the same time, two groups of two years of treatment efficiency and adverse reaction rate. Results After 2 months of treatment, the levels of CEA, TPINP [(25.30 ± 3.20) μg / L], β-CTx [(0.20 ± 0.10) pg / L] (0.10 ± 0.10) g / L] and PTH-r P [(43.20 ± 1.80) ng / L] in the observation group were significantly lower than those in the control group (84.6% (67.3%), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Zoledronic acid combined with NP chemotherapy can effectively reduce the bone metastasis of patients with breast cancer, and the incidence of adverse reactions is low, it is widely used in clinical practice.