唑来膦酸在转移性骨疾病的非小细胞肺癌患者中的应用——一份简短交流。

Under usage of zoledronic acid in non-small cell lung cancer patients with metastatic bone disease--a short communication.

机构信息

The Royal Marsden Hospital, NHS Foundation Trust, Downs Road, Sutton, Surrey, UK.

出版信息

Eur J Cancer. 2011 Jul;47(11):1603-5. doi: 10.1016/j.ejca.2011.05.008. Epub 2011 Jun 16.

DOI:10.1016/j.ejca.2011.05.008

PMID:21684152

Abstract

BACKGROUND AND AIM

The use of zoledronic acid (ZA) is now recommended for patients with NSCLC and metastatic bone disease (MBD). We thus examined the rates of ZA administration in NSCLC looking specifically at the use of this drug with systemic chemotherapy (ZCt) and comparing overall survival between patients who had ZCt from diagnosis to those who had chemotherapy (Ct) alone.

METHOD

In this retrospective audit, we analysed the data of 114 consecutive patients with stage IV NSCLC and MBD at presentation. Forty-three of these patients had received zoledronic acid and chemotherapy (ZCt) and 71 had received chemotherapy alone (Ct).

RESULTS

Forty-three (37.7%, 43/114) of NSCLC patients diagnosed with MBD received ZA with their first chemotherapy (ZCt). Patients on ZCt, after adjustment for the planned prognostic factors (sites of disease, histology and PS), had better overall survival (OS), with a median of 34 weeks, compared to those who received chemotherapy alone, who had a median of 19 weeks (p = 0.03), HR = 0.60 (95%CI: 0.38-0.96). After adjusting for prognostic factors (sex, age. single versus doublet chemotherapy), ZCt patients still maintained a trend to better OS (p = 0.06) HR 0.63 (95%CI: 0.39-1.02) 34 versus 21 weeks.

CONCLUSIONS

The percentage of patients with MBD treated with ZA at first chemotherapy (37.7%) is low. The addition of ZA increased OS in NSCLC patients with MBD in this audit. More formal policies and dedicated trials on the treatment of MBD in NSCLC patients need to be put in place.

摘要

背景与目的

唑来膦酸（ZA）目前被推荐用于非小细胞肺癌（NSCLC）和转移性骨病（MBD）患者。因此，我们专门检查了 NSCLC 患者中 ZA 的使用情况，特别关注了该药物与全身化疗（ZCt）的联合应用，并比较了从诊断开始即接受 ZCt 治疗和单独接受化疗（Ct）治疗的患者的总生存期。

方法

在这项回顾性审计中，我们分析了 114 例初诊为 MBD 的 IV 期 NSCLC 患者的数据。其中 43 例患者接受了唑来膦酸联合化疗（ZCt），71 例患者仅接受了化疗（Ct）。

结果

在诊断为 MBD 的 NSCLC 患者中，有 43 例（37.7%，43/114）在首次化疗时接受了 ZA（ZCt）。在调整了预期预后因素（疾病部位、组织学和 PS）后，接受 ZCt 的患者的总生存期（OS）更好，中位 OS 为 34 周，而单独接受化疗的患者的中位 OS 为 19 周（p=0.03），HR=0.60（95%CI：0.38-0.96）。在调整了预后因素（性别、年龄、单药化疗与双药化疗）后，ZCT 患者的 OS 仍有改善趋势（p=0.06），HR 为 0.63（95%CI：0.39-1.02），中位 OS 分别为 34 周和 21 周。