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[目的]探讨早期静脉应用双膦酸盐在晚期恶性肿瘤治疗中的作用。[方法]128例晚期恶性肿瘤患者分为两组:早期应用双膦酸盐(确诊骨转移之前应用)患者64例为治疗组;未早期应用者64例为对照组。比较双膦酸盐治疗前后VAS疼痛评分和Karnofsky评分以及两组骨转移发生率及确诊时间。[结果]双膦酸盐治疗前后VAS疼痛评分为8.10±1.13,3.10±1.27(t=24.96,P<0.01);Karnofsky评分为57.00±7.80,69.00±8.60(t=8.77,P<0.05)。治疗组骨转移发生率26.56%(17/64),对照组59.37%(38/64),差异有统计学意义(χ2=14.06,P<0.01);治疗组中位骨转移发生时间较对照组延迟3个月(7个月vs 4个月),差异有统计学意义(P=0.038)。[结论]早期应用双膦酸盐治疗晚期恶性肿瘤,能够明显改善生活质量、减轻疼痛;可以减少骨转移发生率,并推迟骨转移发生时间。
[Objective] To explore the role of early intravenous bisphosphonates in the treatment of advanced malignancies. [Method] One hundred and eighty patients with advanced malignant tumor were divided into two groups: 64 patients in the early stage treated with bisphosphonate (used before the diagnosis of bone metastasis) were treated group; 64 patients without early application were the control group. VAS pain scores and Karnofsky scores before and after bisphosphonate treatment were compared between the two groups and the incidence of bone metastases and the time of diagnosis. [Result] The pain scores of VAS before and after bisphosphonate treatment were 8.10 ± 1.13 and 3.10 ± 1.27 (t = 24.96, P <0.01). The Karnofsky scores were 57.00 ± 7.80 and 69.00 ± 8.60 (t = 8.77, P <0.05). The incidence of bone metastasis was 26.56% (17/64) in the treatment group and 59.37% (38/64) in the control group, the difference was statistically significant (χ2 = 14.06, P <0.01) Delayed 3 months (7 months vs 4 months), the difference was statistically significant (P = 0.038). [Conclusion] The early use of bisphosphonates in the treatment of advanced malignant tumors can significantly improve the quality of life and relieve the pain. It can reduce the incidence of bone metastases and delay the time of bone metastases.