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目的观察放疗联合唑来膦酸治疗老年恶性肿瘤骨转移的临床疗效。方法将101例有骨转移的老年恶性肿瘤患者随机分为两组,治疗组51例,给予唑来膦酸抗骨转移治疗,同时给予放疗;对照组50例,对骨转移部位给予放疗。观察两组患者骨病灶的控制率、疼痛缓解率、生活质量改善情况及毒副反应。结果治疗组的骨病灶控制有效率(RR)为60.8%,略高于对照组的50.0%,两组比较无明显统计学差异(P>0.05)。治疗组骨痛的缓解率(显效+有效)为94.1%,明显高于对照组74.0%(P<0.05)。治疗组生活质量改善显效68.6%,明显高于对照组的40.0%(P<0.05)。治疗组和对照组的主要不良反应为白细胞及血小板下降、发热、恶心呕吐、肌肉酸痛、头痛头晕及手足麻木,主要为Ⅰ～Ⅱ级,经对症处理后均好转。结论唑来膦酸联合放疗对于恶性肿瘤骨转移有明确的止痛作用,能改善患者生活质量,不增加不良反应。
Objective To observe the clinical efficacy of radiotherapy combined with zoledronic acid in the treatment of bone metastasis of elderly malignant tumors. Methods A total of 101 elderly patients with bone metastases were randomly divided into two groups. The treatment group received 51 cases of radiotherapy and received radiotherapy. In the control group, 50 patients received radiotherapy. To observe the control rate, pain relief rate, quality of life improvement and side effects of bone lesions in two groups of patients. Results The effective rate of bone lesions control (RR) was 60.8% in the treatment group, slightly higher than that in the control group (50.0%). There was no significant difference between the two groups (P> 0.05). The treatment group pain relief rate (effective + effective) was 94.1%, significantly higher than the control group 74.0% (P <0.05). The quality of life in the treatment group improved significantly 68.6%, significantly higher than the control group 40.0% (P <0.05). The main adverse reactions of the treatment group and the control group were leukopenia and thrombocytopenia, fever, nausea and vomiting, muscle soreness, headache and dizzy and numbness of hands and feet, mainly grade Ⅰ ~ Ⅱ, and were improved after symptomatic treatment. Conclusion Zoledronic acid combined with radiotherapy has a clear analgesic effect on bone metastases of malignant tumors, which can improve the quality of life of patients without increasing adverse reactions.