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1例60岁男性2型糖尿病患者,因小细胞肺癌骨转移,给予帕米膦酸二钠60mg,溶于0.9%氯化钠注射液500ml,于4～5h静脉泵入,1～3个月给药1次,17个月内共给药10次,之后因头颅转移行头部放射治疗。放射治疗前2d开始服用泼尼松10mg,3次/d,连用37d。放射治疗结束后,患者再次接受帕米膦酸二钠治疗,剂量和给药途径同前,1年内共给药5次。在这1年间患者经常出现牙龈肿痛、溢脓,口腔科诊断为下颌骨坏死。考虑下颌骨坏死可能与帕米膦酸二钠有关,或与双膦酸盐和放射治疗两者有关。
A 60-year-old man with type 2 diabetes mellitus received pamidronate disodium 60 mg dissolved in 0.9% sodium chloride 500 ml for 4 to 5 h after intravenous infusion for 1 to 3 months due to bone metastases from small cell lung cancer Administered 1 times, administered within 17 months a total of 10 times, followed by cranial head line radiation therapy. 2d before radiotherapy began to take prednisone 10mg, 3 times / d, once every 37d. After radiotherapy, patients receiving pamidronate disodium again, the dose and route of administration with the former, administered a total of 5 times a year. During these 1 year, patients often showed swollen gums, overflow pus, and dentistry diagnosed as mandibular necrosis. Consider mandibular necrosis that may be related to pamidronate disodium, or to both bisphosphonates and radiation therapy.