| Objective:Pain of bone metastases is one of serious complications of malignancy, often accompanied by limb dysfunction, fracture and even paraplegia. Intolerable pain often turns up. The effect of symptomatic treatment is not ideal, and it can often lead to mental disorders, which will affect the living quality and even threaten to life. Methods such as symptomatic treatment with analgesic drugs, its escalation therapy and nerve block therapy have been using from the past to now. Although the initial effect is fairly ideal, thanks to the failure of tumor control, the treatment effect is on the decline with the growth of tumor. The main treatments of the pain of bone metastases at present are:1. Surgical treatment. The treatment effect of it is good, but the surgery is influenced by many factors such as bone metastatic lesions, general situation, and the estimated lifetime of the patient, so it is difficult to be carried out to the vast majority of patients.2. Chemotherapy. It is an important means of medical treatment of advanced cancer, but patients of bone metastases are influenced by factors such as partial acidosis and blood stasis of the bone metastases parts, so the effect of mere chemotherapy is poor.3. Radiation exposure outside. It is effective to pain under Ⅳ°, but it is limited by the tolerance degree of parts and the body.4. Isotope treatment. It is effective to pain under Ⅱ°but ineffective to pain above Ⅲ°. Besides, the bone marrow suppression is heavy.5. Application of double phosphonic acid salt. The drug is effective to pain under Ⅲ°but ineffective to pain above Ⅳ°. Besides, the immediate relief rate of pain is quite low.6. Biological target therapy. It is the hot point of the present research. However, target therapy is applied in tumor treatment and there are great individual differences. Besides, it costs a lot. As a result, it is difficult to be widely used in clinical application.7. Analgesic therapy. Use drugs according to the three steps analgesic principles of WHO and NCCN guidelines. It is the palliative analgesic treatment and opioid to alleviate the pain of bone cancer is a dose dependent manner, so it is necessary to positively adjust drugs and control untoward effect of drugs. The above treatments are palliative and cannot completely relieve. The ultimately treatment effect is poor and it is limited in improving the living and survival quality of patients. Therefore, discussion about effective therapy for pain of bone metastases and improving lifetime and living quality of patients are hot spots in the current study. Here are the onset characteristics and related theoretical research about pain of bone metastases, those are,①Pain of bone metastases is related to tumor growth, partial tissue acidosis and release of inflammatory factor;②with the increase of the blood viscosity of late cancer patients with bone metastases, the "stasis" of microcirculation blocks the transfer and proliferation of tumor cells as well as reduces the partial drug concentration of tumor, which will reduce the treatment effect and result in tumor spread after the reduction of blood viscosity. We carry out positive chemotherapy to such patients. By calculating the half-life of drug and drug metabolism in the body, we also carry out treatment for activating blood circulation to improve the "stasis" of microcirculation when chemotherapy. And the hone technology to recover high blood viscosity state after the chemotherapy improves the effect of chemotherapy. The objectives of this study are to observe the patients respectively receiving treatment of chemotherapy alone and chemotherapy combined with compound Kushen injection, to compare the clinical effects of the two groups with the grading standard in short-term effects of solid tumor of WHO and the clinical benefit response, to compare the degree of pain relief of the two groups with the visual analogue scale, and to compare the adverse reactions of the two groups with the dividing standard in acute and sub-acute side effects of WHO.Method:Choose61patients of lung adenocarcinoma bone metastases who were confirmed by both pathology and iconography and divide them into treatment group (chemotherapy combined with compound Kushen injection) and control group (chemotherapy alone). All of the patients were admitted by the geriatric oncology department of Shanxi Large Hospital where the tutor of our hospital (Armed Police Corps Hospital of Shanxi Province) from October of2010to October of2013.The specific methods are:(1) Complete the baseline examination of the patients before treatment in order to find out the parts of bone metastases lesions and the bone damage situation.(2) Give a VAS mark before treatment to evaluate the VAS score of the patients as the baseline and record it.(3) Carry out line standard docetaxel+cisplatin chemotherapy, take75mg/m2docetaxel for intravenous drip in the first day and take75mg/m2cisplatin for intravenous drip in the first and second day. The treatment group:Use compound Kushen injection with the standard of30ml/time,1time/day for two weeks and begin to carry out line standard docetaxel+cisplatin chemotherapy in the third day of infusion of compound Kushen injection. The control group:Simply carry out docetaxel+cisplatin chemotherapy. Carry out review after two weeks of treatment and make the curative effect evaluation according to Clinical Benefit Response (CBR), VAS score, evaluation criteria in solid tumors of WHO and classification standard in adverse reactions of WHO.Result:The clinical benefit response of the treatment group is70.9%(22/31) and that of the control group is53.3%(16/30). There is a significant difference between the two groups by comparing.(P<0.05) The recent curative effect of the treatment group is64.5%(20/31) and that of the control group is36.7%(11/30). The comparison of differences between the two groups has statistical significance.(P<0.05) The VAS score of the treatment group reduces from7.42±0.31before treatment to4.24±0.27and that of the control group reduces from7.51±0.28before treatment to5.44±0.22. The comparison of differences between the two groups has statistical significance.(P<0.05) About the hematology toxicity during the period of chemotherapy, the incidence rate of white blood cells reduction of the treatment group is51.6%(16/31) and that of the control group is66.7%(20/30). The comparison of differences between the two groups has statistical significance.(P<0.05) But the comparison of the drop rates of red blood cells and platelets of the two groups has no statistical significance. The incidence rate of gastrointestinal reaction of the treatment group is61.2%(19/31) and that of the control group is66.7%(20/30). There is no significant difference between the two groups by comparing.(P>0.05)Conclusion:For the patients of late lung adenocarcinoma bone metastases pain confirmed by clinic who receive the treatment of DP scheme chemotherapy combined with compound Kushen injection, the half-time of docetaxel injection in the body is11hours, the half-time of cisplatin injection in the body is3-4days and the drug metabolism time of compound Kushen injection is9-10days. By calculating the usage time of drugs, compound Kushen injection is infused to improve the "stasis" of microcirculation to raise the partial blood drug concentration of tumor when chemotherapy. And the hone technology to recover high blood viscosity state after the chemotherapy improves the effect of chemotherapy. It can positively control tumor as well as relieve pain of patients. It can also improve the living quality and provide certain reference to effective antitumor and analgesic therapy to benefit the patients. |
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