| Objective:To evaluate the clinical efficiency and safety of combined treatment of 89strontium(89Sr)and zoledronic acid for bone metastasis of prostate cancer.Methods:We performed a retrospective analysis on 144 cases of advanced prostate cancer patients with bone metastasis who were recruited from the First Affiliated Hospital of Nanchang University from December 2016 to August 2018.All of those patients receive_dcomplete rectal examination(DRE),serum PSA test and transrectal ultrasonography(TRUS)test,as well as rectal prostate biopsy detection.Bone scan image was used to diagnose the bone metastasis.The number of bone metastasis focus in each subject was more than 5.The clinical data included patients' age,diagnosis and treatment of prostate cancer with bone metastasis,bone pain evaluation data and bone scan imaging before and after treatment,and Gleason score.A total of 144 patients were divided into three groups:group A patients receiving intravenous injection of single 89strontium(89Sr)with 4mci in every treatment,and one course every 3 month(39 cases),group B patients receiving intravenous drip of 4mg zoledronic acid together with 100ml physiological salt solution,one treatment every month and one course every 3 month(47 cases),group C patients receiving intravenous drip of 4mg zoledronic acid together with 100ml physiological salt solution at the third or fourth day_after intravenous injection of single 89strontium(89Sr)(28 cases),one zoledronic acid treatment every month and a total of 3 continuous treatment and group D patients receiving single endocrine therapy(30 cases).The follow-up period was 6 months,all of 114 patients received endocrine blocking androgen therapy.The number of bone metastases,the severity of the bone pain,and pain index after treatment,serum TPSA level,the changes of whole blood components and liver function and adverse drug reactions were evaluated according to the outpatient follow-up.We used Pearson x2 test to compare the differences among four treatment groups regarding treatment efficiency,and clinical variables.All p values were calculated using a two-sided test and a p_value<0.05 was considered statistically significant.All of the statistical analyses were performed using SPSS software version 17.0.Results:(1)The efficiency of bone metastases treatment:the efficiency of group A(76.9%)was significantly higher than that of group B(46.8%)(p<0.05);the efficiency of group C(85.7%)was significantly higher than that of group B(46.8%)(p<0.05);the efficiency of group C(85.7%)was higher than that of group A(76.9%)(P>0.05);the efficiency of group B(46.8%)was not significantly higher than that of group D(33.3%)(P>0.05).(2)Bone pain response rate:the response rate of group A(82.1%)was significantly higher than that of group B(61.7%)(p<0.05);the response rate of group C(89.3%)was significantly higher than that of group B(61.7%)(P<0.05);the response rate of group C(89.3%)was higher than that of group A(82.1%),which was not statistically significant(P>0.05);the response rate of group B(61.7%)was higher than that of group D(46.7%),which was not statistically significant(P>0.05).(3)Adverse drug reactions(ADR):The major ADR event in single 8"strontium(89Sr)treatment group is bone marrow suppression(7.7%).However,the common ADR events in single zoledronmc acid treatment group include fever(12.6%)and digestive system symptoms(4.2%)Conclusions:(1)Decreased number and concentration degree of prostate cancer bone metastases focus:The therapeutic effect of 89strontium(89Sr)chloride combined with zoledronic acid was better than that of zoledronic acid and endocrine alone.(2)Bone pain response rate:The therapeutic effect of 89strontium(89Sr)chloride combined with zoledronic acid was better than that of zoledronic acid and endocrine alone.(3)89Sr and zoledronic acid have synergistic effect on the treatment of Bone Metastasis of prostate cancer:combined treatment not only significantly relieves the bone pain but also significantly inhibits bone metastases.(4)Adverse drug reactions(ADR):compared to single 89Sr or single zoledronic acid treatment,no ADR events significantly increased in the group of combined 89strontium(89Sr)and zoledronic acid treatment... |
PDF Full Text Request