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唑来膦酸联合帕米膦酸二钠治疗非小细胞肺癌骨转移及对疼痛应激和骨代谢指标的影响。

Combined chemotherapy of zoledronic acid and pamidronate in the treatment of bone metastases from nonsmall cell lung cancer and the effects on pain stress and bone metabolic indices.

机构信息

Department of Orthopaedics, Guiyang Yunyan District People's Hospital, Guiyang, Guizhou, China.

Department of Rheumatism, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.

出版信息

Drug Dev Res. 2024 Feb;85(1):e22147. doi: 10.1002/ddr.22147.

Abstract

OBJECTIVE

We conducted this paper to decipher the efficacy of the combined chemotherapy of zoledronic acid and pamidronate in treating bone metastases from nonsmall cell lung cancer (NSCLC) and the effects on pain stress and bone metabolic indices.

METHODS

Patients with bone metastases from NSCLC were allocated into Group A and Group B. Patients in the Group A were administrated with pamidronate combined chemotherapy and patients in the Group B were administrated with zoledronic acid combined chemotherapy. The efficacy, pain symptom scores, quality of life scores, serum inflammatory factor, serum bone metabolic indices, serum pain stress indicators, and the occurrence of adverse effects were compared in patients of the two groups.

RESULTS

The total effective rate of treatment was higher in the Group B than in the Group A. After treatment, reduced Numerical Rating Scale scores and elevated Karnofsky Performance Score score, reduced serum levels of N-terminal mid-fragment of osteocalcin, N-terminal propeptide of type I procollagen, bone-specific alkaline phosphatase, and type I collagen hydroxyl terminal peptide β special sequence, reduced serum levels of C-reactive protein, procalcitonin, tumor necrosis factor-α, and interleukin-6, as well as decreased levels of bradykinin, substance P, neuropeptide Y, and β-endorphin were found in the Group B versus the Group A. No notable difference was witnessed in the rate of adverse reactions between the Group A and the Group B.

CONCLUSION

Zoledronic acid combined with chemotherapy can effectively treat bone metastases of NSCLC and improve pain stress and bone metabolic status, which has value that can be promoted and applied in clinical treatment.

摘要

目的

本研究旨在探讨唑来膦酸联合帕米膦酸二钠治疗非小细胞肺癌(NSCLC)骨转移的疗效及其对疼痛应激和骨代谢指标的影响。

方法

将 NSCLC 骨转移患者分为 A 组和 B 组。A 组患者接受帕米膦酸二钠联合化疗,B 组患者接受唑来膦酸联合化疗。比较两组患者的疗效、疼痛症状评分、生活质量评分、血清炎症因子、血清骨代谢指标、血清疼痛应激指标及不良反应发生情况。

结果

B 组治疗总有效率高于 A 组。治疗后,B 组的数字评分量表(NRS)评分降低,卡氏功能状态评分(KPS)升高,血清 N 端中段骨钙素(N-MID)、I 型前胶原氨基端前肽(PINP)、骨碱性磷酸酶(BALP)和 I 型胶原羟基端肽 β特殊序列(β-CTX)水平降低,血清 C 反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平降低,缓激肽(BK)、P 物质(SP)、神经肽 Y(NPY)和β-内啡肽(β-EP)水平降低。A 组与 B 组不良反应发生率无显著差异。

结论

唑来膦酸联合化疗能有效治疗 NSCLC 骨转移,改善疼痛应激和骨代谢状况,具有临床推广应用价值。

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