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目的研究唑来膦酸联合NP化疗治疗乳腺癌骨转移的近期疗效及患者的耐受度。方法选取2012年6月至2015年6月乳腺癌骨转移患者55例,随机分为观察组30例和对照组25例。对照组给予单纯NP化疗治疗,观察组给予唑来膦酸联合NP化疗治疗。分析两组治疗疗效,观察和比较两组治疗前后血清相关指标,包括糖类抗原(CA153)、Ⅰ型胶原羧基末端肽(CTx)、Ⅰ型胶原交联氨基末端肽(NTx)、Ⅰ型胶原羧基端前肽(PICP),比较两组治疗前后疼痛评分及不良反应发生情况。结果观察组总有效率为83.33%,显著高于对照组的56.00%(P<0.05);两组治疗前骨代谢CA153、CTx、NTx、PICP各水平比较差异未见统计学意义(P>0.05),治疗后观察组骨代谢CA153(13.99±4.83)Ku/L、CTx(0.21±0.11)μg/L、NTx(16.26±7.34)C/(nmmo/L)、PICP(39.53±20.51)μg/L与对照组相比均显著降低(P<0.05);治疗后,观察组疼痛评分为(2.95±2.72)分,与对照组的(4.51±2.06)分相比显著较低(P<0.05);观察组不良反应发生率低于对照组,但差异未见统计学意义(P>0.05)。结论唑来膦酸联合NP化疗治疗乳腺癌骨转移患者疗效显著,能显著降低患者血清各项骨代谢相关指标水平,且能缓解患者疼痛程度,患者耐受度高。
Objective To study the short-term efficacy and patient tolerance of zoledronic acid combined with NP chemotherapy for the treatment of breast cancer with bone metastases. Methods 55 patients with breast cancer with bone metastasis from June 2012 to June 2015 were randomly divided into observation group (30 cases) and control group (25 cases). The control group received simple NP chemotherapy and the observation group received zoledronic acid combined with NP chemotherapy. The curative effect of the two groups was analyzed. The serum related indices including carbohydrate antigen (CA153), type Ⅰ collagen carboxyterminal peptide (CTx), type Ⅰ collagen cross-linked amino terminal peptide (NTx), type Ⅰ collagen Carboxyl-terminal propeptide (PICP), before and after treatment, pain scores and adverse reactions were compared. Results The total effective rate in the observation group was 83.33%, which was significantly higher than that in the control group (56.00%, P <0.05). There was no significant difference in the levels of CA153, CTx, NTx and PICP between the two groups before treatment (P> 0.05 ) After treatment. The levels of CA153 (13.99 ± 4.83) Ku / L, CTx (0.21 ± 0.11) μg / L and NTx (16.26 ± 7.34) C / (nmmo / L) and PICP (39.53 ± 20.51) μg / L was significantly lower than that of the control group (P <0.05). After treatment, the pain score of the observation group was (2.95 ± 2.72) points, which was significantly lower than that of the control group (4.51 ± 2.06) The incidence of adverse reactions in observation group was lower than that in control group, but the difference was not statistically significant (P> 0.05). Conclusion Zoledronic acid combined with NP chemotherapy in the treatment of breast cancer patients with bone metastases significant effect, can significantly reduce the level of serum bone metabolism related indicators, and can relieve pain in patients with high patient tolerance.