Clinical Analysis Of 217 Patients With Metastatic Carcinoma Of Bone

Objective To investigate and analyze the clinical features of bone metastatic carcinoma and the analgesic effect of zoledronic acid,in which improve the diagnosis and treatment of bone metastatic carcinoma.Methods The clinical data of 217 patients with bone metastases were collected from April 2012 to March 2016 in the affiliated Orthopaedic Hospital of North China University of Science and Technology.All cases were confirmed as malignant tumors by pathological and imaging data and bone metastases.The clinical data of 217 patients with metastatic carcinoma of bone was retrospectively analyzed.The clinical features were summarized,including primary tumor,age distribution,first symptom,time of onset and bone metastatic site.Visual analogue scale(VAS)was used to evaluate the pain difference of bone metastases in 108 patients treated with zoledronic acid before and after treatment.Results Clinical characteristics:Among 217 patients with bone metastases,122 were males and 95 females,the ratio of male to female was 1.28: 1,the age was 19 ~ 87 years old,the median age was 56 years old.The peak of the disease was between 50 and 70 years old,with 140 cases accounting for 64.52% of all patients.Primary tumors in lung cancer(51.61%),breast cancer(15.67%),renal cell carcinoma(10.60%),prostate cancer(3.69%),and thyroid carcinoma(3.69%)were relatively common.The proportions of patients with a previous history of malignant tumors were lung cancer(24.11%),breast cancer(100%),renal cell carcinoma(30.43%),prostate malignant tumors were lung cancer(24.11%),breast cancer(100%),renal cell carcinoma(30.43%),prostate cancer(37.50%),and thyroid carcinoma(75.00%).Most of the patients with metastatic carcinoma of bone initially showed varying degrees of pain,others with dysfunction,pathological fracture,or local lumps as the initial symptoms,Only a tiny minority were inadvertently found.Onset time was often within 3 months,which accountings for 54.84%.The sites of bone metastases were the thoracic spine(37.33 %),lumbar spine(34.10%),pelvis(28.11%),femur(27.19%),ribs(24.88%),and sacrum(15.21%).The vast majority of bone metastases showed multiple(80.18%).Analgesic effect:The VAS score of 108 patients with pain of bone metastases before treatment was 6~10(8.02 �0.88).After treatment with zoledronic acid,the mean value was 0~4(1.31�1.07).The difference of pain in bone metastases was statistically significant(P < 0.01).There were 17 cases of adverse reactions including fever,transient hypotension and systemic muscle soreness.After symptomatic treatment 24 hours or 48 hours of automatic regression and no recurrence,no other obvious side effects.Conclusions The majority of bone metastases were multiple,and the spine was the most common site of bone metastasis.The primary tumors were mainly lung cancer and breast cancer.Most of the patients with bone metastases suffered from pain at first,and a few with dysfunction.Pathological fracture,local mass as the first symptom,individual inadvertent discovery.The peak of bone metastases was found in middle and old people,and the onset time was less than 3 months.Zoledronic acid could effectively relieve the pain symptoms of metastatic foci.The early diagnosis and effective treatment of bone metastatic carcinoma is still a major issue.We should constantly strengthen the basic research on molecular mechanism of bone metastatic carcinoma and summarize and analyze the clinical characteristics of bone metastatic carcinoma,so as to provide reliable basis for clinical diagnosis and treatment.In order to improve the therapeutic effect,alleviate the pain of the patients,improve the quality of life and prolong the life span of the patients.