唑来膦酸联合同期放化疗治疗晚期乳腺癌骨转移的临床效果
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摘要
目的探讨唑来膦酸联合同期放化疗治疗晚期乳腺癌骨转移的临床效果。方法选取2016年1月～2018年1月在冀中能源邢台矿业集团总医院治疗的晚期乳腺癌骨转移患者107例,根据最终选取的冶疗方案将患者分为观察组(n=53)和对照组(n=54),其中观察组给予唑来膦酸联合同期放化疗治疗,对照组给予放化疗治疗,观察两组治疗效果、视觉模拟(VAS)评分及不良反应,同时检测治疗前后血清钙和血管内皮生长因子(VEGF)水平。结果观察组治疗效果优于对照组(P <0.05);观察组和对照组治疗前VAS评分比较,差异无统计学意义(P>0.05);观察组和对照组治疗后VAS评分较治疗前降低(P <0.05);观察组治疗后VAS评分明显低于对照组治疗后(P <0.05);观察组和对照组治疗前血清钙和VEGF比较,差异无统计学意义(P> 0.05);两组治疗后血清钙和VEGF较治疗前降低(P <0.05);且观察组治疗后血清钙和VEGF明显低于对照组(P <0.05);观察组和对照组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论唑来膦酸联合同期放化疗治疗晚期乳腺癌骨转移有较好的临床效果,值得临床使用。
Objective To investigate clinical effect of Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of bone metastasis of advanced breast cancer. Methods From January 2016 to January 2018, 107 patients with bone metastasis of advanced breast cancer who were treated in the Jizhong Energy General Hospital of Xingtai Mining Group were selected, and they were divided into observation group(n = 53) and control group(n = 54) according to the treatment plan finally. The observation group was treated with Zoledronic acid combined with concurrent chemoradiotherapy, while the control group was treated with chemoradiotherapy. The therapeutic effect, visual analogue(VAS) score and adverse reactions of the two groups were observed, and serum calcium and vascular endothelial growth factor(VEGF) levels were detected before and after treatment. Results The curative effect of the observation group was better than that of the control group(P < 0.05), there was no significant difference in VAS score between the observation group and the control group before treatment(P > 0.05). The VAS score of the observation group and the control group after treatment were lower those that before treatment(P < 0.05), the score of VAS in the observation group after treatment was significantly lower than that in the control group after treatment(P < 0.05). There was no significant difference in serum calcium and VEGF between the observation group and the control group before treatment(P > 0.05), the serum calcium and VEGF in the observation group and the control group after treatment were lower than those before treatment(P < 0.05). The serum calcium and VEGF in the observation group after treatment were significantly lower than those in the control group after treatment(P < 0.05), there was no significant difference in the incidence of adverse reactions between the observation group and the control group(P > 0.05). Conclusion Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of advanced breast cancer has good clinical effect, and is worthy of clinical application.
Objective To investigate clinical effect of Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of bone metastasis of advanced breast cancer. Methods From January 2016 to January 2018, 107 patients with bone metastasis of advanced breast cancer who were treated in the Jizhong Energy General Hospital of Xingtai Mining Group were selected, and they were divided into observation group(n = 53) and control group(n = 54) according to the treatment plan finally. The observation group was treated with Zoledronic acid combined with concurrent chemoradiotherapy, while the control group was treated with chemoradiotherapy. The therapeutic effect, visual analogue(VAS) score and adverse reactions of the two groups were observed, and serum calcium and vascular endothelial growth factor(VEGF) levels were detected before and after treatment. Results The curative effect of the observation group was better than that of the control group(P < 0.05), there was no significant difference in VAS score between the observation group and the control group before treatment(P > 0.05). The VAS score of the observation group and the control group after treatment were lower those that before treatment(P < 0.05), the score of VAS in the observation group after treatment was significantly lower than that in the control group after treatment(P < 0.05). There was no significant difference in serum calcium and VEGF between the observation group and the control group before treatment(P > 0.05), the serum calcium and VEGF in the observation group and the control group after treatment were lower than those before treatment(P < 0.05). The serum calcium and VEGF in the observation group after treatment were significantly lower than those in the control group after treatment(P < 0.05), there was no significant difference in the incidence of adverse reactions between the observation group and the control group(P > 0.05). Conclusion Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of advanced breast cancer has good clinical effect, and is worthy of clinical application.
引文
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[19]张锐,王智煜,王帅,等.重组人血管内皮抑素联合NP方案治疗初诊晚期非小细胞肺癌骨转移疗效及对血清VEGF表达的影响[J].实用肿瘤学杂志,2016,30(6):527-532.DOI:10.11904/j.issn.1002-3070.2016.06.010.
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[23]孟佳,王秋军,范鹰,等.双膦酸盐预治疗减少首次应用唑来膦酸不良反应的研究[J].中国骨质疏松杂志,2017,23(7):938-941.DOI:10.3969/j.issn.1006-7108.2017.07.021.
[2]胡群超,俞晓立,郭小毛,等.放疗在乳腺癌骨转移中的临床应用进展[J].中国癌症杂志,2016,26(4):346-350.DOI:10.3969/j.issn.1007-3969.2016.04.010.
[3]曹莹莹,王增,方罗,等.浙江省11家医院2010-2015年双膦酸盐类药物治疗乳腺癌骨转移相关骨损害及疼痛的利用研究[J].中国药房,2018,29(8):1061-1065.DOI:10.6039/j.issn.1001-0408.2018.08.12.
[4]王如良,江泽飞.骨改良药物在乳腺癌骨转移治疗中的应用进展[J].临床肿瘤学杂志,2016,21(5):458-461.
[5]张雪惠,陈月凤,薛小军,等.整形保乳术与常规保乳术治疗早期乳腺癌比较[J].现代仪器与医疗,2017,23(2):39-40.DOI:10.11876/mimt201704016.
[6]戴毅君,许建华.120例激素受体阳性晚期乳腺癌的临床观察[J].中国现代医生,2017,55(11):62-64,67.
[7]王慧,唐丹,王瑜.多元化延续性护理在乳腺癌患者康复中的实践与评估[J].中国医学创新,2017,14(11):82-85.
[8]何玉峰,陈进,鲁光平,等.来曲唑联合唑来膦酸治疗ER/PR阳性的绝经后乳腺癌骨转移疗效分析[J].山东医药,2016,56(35):65-67.DOI:10.3969/j.issn.1002-266X.2016.35.021.
[9]邹燕鹏,孙宇,闻国权,等.血液OSC、OPG、NTX和尿液NTX的改变与乳腺癌骨转移治疗效果之间的关系研究[J].中国医学创新,2017,14(31):8-11.
[10]王深明,单臻.应重视骨微环境在乳腺癌骨转移中的重要性[J].中华实验外科杂志,2017,34(4):541-543.DOI:10.3760/cma.j.issn.1001-9030.2017.04.001.
[11]杨慧,邱玲,林建国,等.唑来膦酸治疗乳腺癌及其骨转移的研究进展[J].现代肿瘤医学,2016,24(8):1306-1310.DOI:10.3969/j.issn.1672-4992.2016.08.040.
[12]周婕,何伟星,敖翔,等.乳腺癌骨转移放疗后的生存预测因素分析[J].广东医学,2016,37(15):2287-2290.
[13]陆颖,黄海欣,杨慧,等.局部晚期乳腺癌改良根治术后多西他赛同步放化疗的放射性不良反应观察[J].中国肿瘤临床,2016,43(10):438-441.DOI:10.3969/j.issn.1000-8179.2016.10.120.
[14]黄维,董嘉尧,周成宇,等.紫杉醇同步放化疗在中晚期乳腺癌细胞增殖抑制中的作用及并发症预防对策[J].海南医学院学报,2016,22(14):1594-1596,1600.DOI:10.13210/j.cnki.jhmu.20160408.003.
[15]孙达统,王琳,曾爱辉,等.局部晚期乳腺癌患者术后给予同步放化疗的毒副反应耐受性研究[J].现代中西医结合杂志,2016,25(26):2939-2941.DOI:10.3969/j.issn.1008-8849.2016.26.031.
[16]胡夕春.乳腺癌骨转移唑来膦酸研究新证据之解读[J].中华医学杂志,2016,96(12):915-917.DOI:10.3760/cma.j.issn.0376-2491.2016.12.002.
[17]谷振坤,任媛媛,杜晓琅,等.唑来膦酸在乳腺癌中抗肿瘤差别化效应的研究进展[J].天津医药,2016,44(9):1177-1180.DOI:10.11958/20160213.
[18]孟祥颖,宋三泰.乳腺癌骨转移药物治疗的疗效评价及分类处理[J].中华肿瘤杂志,2017,39(3):161-165.DOI:10.3760/cma.j.issn.0253-3766.2017.03.001.
[19]张锐,王智煜,王帅,等.重组人血管内皮抑素联合NP方案治疗初诊晚期非小细胞肺癌骨转移疗效及对血清VEGF表达的影响[J].实用肿瘤学杂志,2016,30(6):527-532.DOI:10.11904/j.issn.1002-3070.2016.06.010.
[20]郭玉兴,王佃灿,王洋,等.二膦酸盐药物治疗乳腺癌骨转移发生颌骨坏死的临床特点[J].北京大学学报:医学版,2016,48(1):80-83.DOI:10.3969/j.issn.1671-167X.2016.01.014.
[21] Sugie T,Suzuki E,Yamauchi A,et al. Combined effectsof neoadjuvant letrozole and zoledronic acid on st cancer;bone metastasis; clinical efferly-stage breast cancer[J].Breast,2018,12(38):114-119.
[22]李静平,刘运江.唑来膦酸应用于乳腺癌辅助治疗的研究[J].临床外科杂志,2016,24(3):231-233.DOI:10.3969/j.issn.1005-6483.2016.03.024.
[23]孟佳,王秋军,范鹰,等.双膦酸盐预治疗减少首次应用唑来膦酸不良反应的研究[J].中国骨质疏松杂志,2017,23(7):938-941.DOI:10.3969/j.issn.1006-7108.2017.07.021.