负荷剂量伊班膦酸钠与常规剂量唑来膦酸联合化疗胃癌骨转移的疗效观察

摘要

目的 探究负荷剂量伊班膦酸钠与常规剂量唑来膦酸联合化疗对胃癌骨转移患者的治疗效果.方法 收集经CT、核磁共振或骨扫描确诊的胃癌骨转移患者共计63例,随机分为观察组(n = 31)与对照组(n = 32).对照组给予FOLFOX方案化疗,观察组在FOLFOX化疗的基础上再给予负荷剂量伊班膦酸钠与常规剂量唑来膦酸.比较两组患者的血清钙离子、Ⅰ型胶原吡啶交联终肽(ICTP)、碱性磷酸酶(BAP)、beta-碳端肽(beta-CTX)、降钙素(OC)等骨吸收生化指标水平、KPS评分、治疗有效率、疾病控制率与治疗期间死亡率.采用Kaplan-Meier法和对数秩检验(log-rank test)进行生存分析,比较两组患者的中位生存期(median survival time,MST)及总生存率(overall survival,OS).结果 与对照组相比,观察组患者的血钙、ICTP、BAP、beta-CTX与OC等指标水平降低,KPS评分、治疗有效率、疾病控制率皆提高,治疗期间死亡率明显降低,且差异均具有统计学意义(P ＜ 0.05).生存分析显示,同对照组相比,观察组患者的中位生存期延长,总生存率提高,差异具有统计学意义(P = 0.026).结论 在FOLFOX全身化疗的基础上,给予负荷剂量伊班膦酸钠与常规剂量唑来膦酸联合化疗对胃癌骨转移患者的疗效显著,具有一定的临床推广价值.%Objective To investigate the therapeutic effect of combined chemotherapy of loading dose ibandronate sodium and conventional dose zoledronic acid on patients with bone metastasis of gastric cancer. Methods 63 patients with bone metastasis of gastric cancer diagnosed by CT,MRI or bone scan were collected and randomly divided into observation group (n = 31) and control group (n = 32). The control group was given FOLFOX chemotherapy,while the observation group was given loading dose of ibandronate sodium and conventional dose of zoledronic acid on the basis of FOLFOX chemotherapy. The levels of blood calcium, serum type I collagen pyridine cross-linked terminal peptide (ICTP), alkaline phosphatase (BAP),beta-carbon terminal peptide (beta-CTX), calcitonin (OC),KPS score, treatment efficiency,disease control rate and mortality during treatment were compared between the two groups. Survival analysis was performed by Kaplan-Meier and logarithmic rank test (log-rank test), the median survival time (MST) and overall survival (OS) of the two groups were compared. Results Compared with the control group, the serum calcium, ICTP,BAP,beta-CTX and OC in observation group were lower,KPS score, treatment efficiency,disease control rate were improved,while mortality during treatment was reduced,and the difference was statistically significant (P ＜ 0.05). Survival analysis showed that compared with control group, the MST of observation group was prolonged and the OS was improved (P = 0. 026). Conclusion On the basis of FOLFOX systemic chemotherapy,combined with loading dose of ibandronate sodium and conventional dose of zoledronic acid has a significant effect on patients with bone metastasis of gastric cancer, which has broad prospects of clinical application.