| Objective: Retrospective analysis of688cases of bone metastasis of cancerpatients with clinical features and treatment, realizing the general biology of bonemetastases characteristics and treatment of the current situation.Methods: Collected688bone metastases patients with complete clinical datawho have been confirmed multiple bone metastases and single bone metastases(confirmed by CT) by the whole-body bone scan in First Affiliated Hospital of DalianMedical University ECT room from January2008to December2010，and the survivalof these patients were greater than or equal to3months，if using the bisphosphonatestreatment，the number of treatments is greater than or equal to two times，toretrospectively analyze the clinical characteristics and treatment of bone metastasespatients，to investigate the analgesic effect，adverse reactions and impact on patientsurvival of different bone metastasis cancer treatment options.Results: Clinical biological characteristics：The median age of the688patientswas61.17±11.60years，male patients were340cases，and female patients were348cases（the ratio is0.98:1）. The primary tumor mainly from lung cancer, breast cancer,prostate cancer（about79.94%）.Multiple bone metastases608cases (accounting for88.37%). At the time of diagnosis, there were32cases without symptoms of bonemetastases，656cases having varying degrees of bone pain，32cases havingpathologic fractures and84cases having spinal cord compression, but having nohypercalcemia.Analgesic effect：By the chi-square test, bisphosphonates+strontium-89+othertreatment regimens have the highest efficiency and significant efficiency rate of83.33%and27.78%，bisphosphonates+other treatment regimens have the efficiencyand significant efficiency rate of70.44%and13.86%，single bisphosphonates treatment have the efficiency and significant efficiency rate of62.5%and0%.Othertreatment regimens alone have the efficiency and significant efficiency rate of51.85%and12.59%. By the view of the efficiency rate：the analgesic effect between thesimple bisphosphonate treatment and single other treatment was no significantdifference，but the analgesic effect in combination therapy was better than singleapplication（P<0.05）. Joint strontium-89treatment had the highest efficiency rate（P<0.05）. By the view of the significant efficiency rate：Plus strontium-89treatmentstill had obvious advantage（sP<0.05）. Simple bisphosphonate treatment group did nothave patients with markedly remission. There was also no obvious advantage in othertherapy+bisphosphonate treatment. And the pain medication reduction after treatmentcan indirectly prove the advantages of bisphosphonates+strontium-89+othertreatment regimens on the analgesic effect.Adverse reactions：The adverse reactions of simple bisphosphonates treatmentare mild. Joint strontium-89therapy will increase the patient’s fatigue symptoms (P<0.05), and have high bone marrow suppression incidence，but did not increase theresponse of the gastrointestinal tract, liver and kidney dysfunction and cardiactoxicity.Survival analysis：Until March31，2012，the survival of all patients was from3to53months，the average overall survival was15.28months, and1year survivalrate was53.78%. Median overall survival of group A was7.81(months),1-yearsurvival rate was25%；median overall survival of group B was22.97(months),1-yearsurvival rate was62.80%；median overall survival of group C was19.62(months),1-year survival rate was72.22%；the median overall survival of group D was16.66(months),1-year survival rate was44.52%. Through the lifetime comparison of thefour groups of treatment programs，we found that bisphosphonates+other treatmentregimens was able to prolong overall survival period (P <0.05)，also improve thepatient’s1-year survival (P <0.05).And lung cancer and breast cancer subgroupsfurther confirmed the above findings (P <0.05). Joint with strontium-89therapy didnot significantly prolong survival. Prostate cancer subgroup analysis showed thatwhether other treatment joint or non-joint with bisphosphonates treatment, the overallsurvival and1-year survival was no significant difference. But other cancer subgroupanalysis showed that after the bisphosphonates+strontium-89+other treatmentregimens，patients had the longest survival，well the bisphosphonates+othertreatment options followed by (P <0.05). Conclusion: Most bone metastasis of cancer is multiple bone metastases，theprimary disease mainly to the lung cancer, breast cancer and prostate cancer，and bonepain is the main clinical symptoms. Bisphosphonates alone or in combination withstrontium89irradiation can improve the relief rate of pain. The analgesic effect ofaddition of strontium-89treatment is the best，and the adverse reactions were mild andtolerable. The bisphosphonates joint other treatments compared with purebisphosphonates therapy or other treatment alone，can prolong the survival of patients,increase the1-year survival rate. |
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