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目的 探讨二膦酸盐类药物对晚期前列腺癌骨转移疼痛的治疗价值。 方法 回顾性分析 4 0例因骨转移导致骨痛的晚期前列腺癌患者资料 ,无肝肾功能不全和病理性骨折 ,按去势后病情和治疗分为 3组 :A组 1 2例 ,切除睾丸后口服抗雄激素药物加服氯甲膦酸二钠 (固令 ) ;B组 1 7例 ,切除睾丸后口服抗雄激素药物 ;C组 1 1例 ,诊断为雄激素非依赖性前列腺癌 ,口服固令。采用视觉模拟疼痛评分 (VAS)和Karnofsky生活质量评分对 3组患者治疗前与治疗后 2、4周的疼痛程度与生活质量进行比较分析。 结果 4周后 ,3组患者的骨痛明显改善 ,治疗前后VAS评分 :A组 7.3/ 2 .5 ,B组7.6 / 2 .3,C组 7.9/ 4 .6 ,P <0 .0 5 ;生活质量明显提高 ,治疗前后Karnofsky评分分别为 :A组 4 5 / 70 ,B组 4 0 / 70 ,C组 4 0 / 6 0 ,P <0 .0 5。 4例 (1 0 % )患者发生轻度恶心、呕吐和腹泻。 结论 二膦酸盐类药物是缓解晚期前列腺癌骨痛的有效手段
Objective To investigate the therapeutic value of bisphosphonates on bone metastasis of advanced prostate cancer. Methods A retrospective analysis of 40 cases of advanced prostate cancer patients with bone pain due to bone metastases, without liver and kidney dysfunction and pathological fractures, according to the castration condition and treatment were divided into 3 groups: A group of 12 cases, resection of the testis After oral administration of anti-androgen drugs plus chloromethylphosphonate disodium (solid pressure); B group of 17 cases, after removal of testicular oral anti-androgen drugs; C group 11 cases, androgen independent diagnosis of prostate cancer, Oral fixation. Visual acuity pain scores (VAS) and Karnofsky quality of life scores were used to compare the pain and quality of life before and after 2 and 4 weeks of treatment in the three groups. Results After 4 weeks, the pain scores of the three groups were significantly improved. The VAS scores of group A were 7.3 / 2.5, group B 7.6 / 2.3, group C 7.9 / 4.6, P <0.05 before and after treatment. The quality of life improved significantly. The Karnofsky scores before and after treatment were 45/70 in group A, 40/70 in group B, 40/60 in group C, P <0.05. Four patients (10%) developed mild nausea, vomiting and diarrhea. Conclusion Bisphosphonates are an effective way to relieve the pain of advanced prostate cancer