Clinical Study On Diagnosis And Treatment Of Lung Cancer With Bone Metastasis

Objective: The clinical materials of 63 patients with lung cancer with bone metastasis were retrospectively analysed.Methods: 63 consecutive cases were analyzed with bone scanning and compared with other radioiogical examinations (MRI, CT and X-ray). All cases were confirmed by cytology and / or histological. They were randomized divided into two groups: Group A :30 cases(the same period of radiotherapy and chemotherapy plus pamidronate;) and group B: 33 cases(Sequential radiotherapy and chemotherapy + pamidronate). All patients were followed up more than 1 yearResults: The most cases were mainly adenocarcinoma (65.1%), the peak age of incidence was 50 - 69 years old (76.2%). 27 cases of 63 cases was single bone metastasis( 42.9%). 36 cases was multiple bone metastasis(57.1%). The rib bone was the most frequent metastatic sites(17.5%).CEA, AKP, SF, Ca²⁺ were detected in all patients, the positive rates were 57.1%, 60.3%, 36.5%, 19.1%,respectively. The pain relief rate (CR + PR) was 86.7% in group A, 39.4% in group B. There was significant difference between group A and group B(χ²= 5.4167, P = 0.02). The total effective rate of partial lesion (CR + PR) was 60.0% in group A, 33.3% in group B. There was significant difference between group A and group B(χ² = 4.4982, P = 0.034) ; 1-year survival rate in two groups was 43.3%, 16.7%, 2-year survival rate 45.5%, 9.1%.2-year survival rate was significant difference between group A and group B(χ²= 0.0700, P = 0.000); The side effects were gastrointestinal reactions, bone marrow suppression, radioactive esophagitis, radioactive bronchitis and pneumonia, but tolerable. The quality of life was no significant difference between before and after treatment, group A and group B.Conclusion: Adenocarcinoma has the highest rate of osseous matastasis. Imaging and serological tests were useful for the diagnosis of bone metastases. The comprehensive treatment based on radiotherapy and chemotherapy can significantly reduce the symptoms, extend the survival period of patients.