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目的:探讨放射性核素氯化锶(89SrCl2)与唑来膦酸联合治疗转移性骨肿瘤的临床效果。方法:采用随机、双盲、双模拟和多中心的实验设计方法。采用随机方法将97例转移性骨肿瘤患者分为两组,单项治疗组51例,采用89SrCl2治疗;联合治疗组46例,用89SrCl2与唑来膦酸治疗,观察疗效。结果:89SrCl2单项治疗组51例患者,治疗后疼痛反应有效27.5%(14/51),显效49.0%(25/51),总有效率达76.5%(39/51);骨转移灶治疗后有效5.9%(3/51),显效27.4%(14/51),总有效率达到33.3%(17/51)。89SrCl2与唑来膦酸联合治疗组46例患者,治疗后疼痛反应有效41.3%(19/46),显效50.0%(23/46),总有效率达91.3%(42/46);骨转移灶治疗后有效6.5%(3/46),显效32.6%(15/46),总有效率达到39.1%(18/46)。联合治疗组止痛的疗效高于单项治疗组,差异有统计学意义,P<0.05;消退转移灶的疗效与单项治疗组相同。结论:89SrCl2与唑来膦酸对转移性骨肿瘤所致疼痛有明显疗效,同时还可部分消退转移病灶,且安全无不良反应,联合治疗效果优于89SrCl2单项治疗。
Objective: To investigate the clinical effect of strontium chloride (89SrCl2) combined with zoledronic acid in the treatment of metastatic bone tumors. Methods: Randomized, double-blind, double-simulations and multicentre experimental design methods were used. A total of 97 patients with metastatic bone tumors were divided into two groups randomly. Fifty-one patients were treated with 89SrCl2 and 46 patients were treated with 89SrCl2 and zoledronic acid respectively. The curative effect was observed. Results: In the 89SrCl2 monotherapy group, the pain response was effective in 27.5% (14/51), effective rate was 49.0% (25/51), and the total effective rate was 76.5% (39/51) in 51 patients. The effective rate of bone metastases 5.9% (3/51), markedly effective 27.4% (14/51), the total effective rate reached 33.3% (17/51). Among the 46 patients treated with 89SrCl2 and zoledronic acid, the pain response rate was 41.3% (19/46) after treatment, with a significant effect of 50.0% (23/46) and the total effective rate was 91.3% (42/46). The bone metastases After treatment, effective 6.5% (3/46), effective 32.6% (15/46), the total effective rate was 39.1% (18/46). The curative effect of analgesic in combined treatment group was higher than that in single treatment group, the difference was statistically significant (P <0.05). The curative effect of metastasis was the same as that of single treatment group. CONCLUSIONS: 89SrCl2 and zoledronic acid have obvious curative effect on the pain caused by metastatic bone tumor. At the same time, 89SrCl2 can partly eliminate the metastatic lesions and have no adverse reactions. The combined treatment is superior to 89SrCl2 single treatment.