双膦酸盐积在肺癌中骨转移的进展.pptVIP

* * Bone metastases occur in 20–40% of patients with lung cancer. Recent studies demonstrate a direct antiproliferative effect of 3rd generation bisphosphonates (BPs) on lung tumors, which may influence the survival. Therefore, we examined the clinical impact of zoledronic acid (ZOL; Zometa1), a 3rd generation BP, with a focus on the survival, time to progression and pain effect in lung cancer patients with bone metastases. Lung cancer patients (n 5 144, Stage IV) with evidence of metastasis bone scan were included. Eighty-seven of 144 experienced bone pain and received ZOL, 4 mg i.v. every 21 days (Group A), whereas the other 57 patients received no ZOL (Group B). All patients were treated with a combination chemotherapy consisted of docetaxel 100 mg/ m2 and carboplatin AUC 5 6. It was found that Group A had a statistically significant longer survival (p 0.01) when compared to Group B. A statistically significant positive correlation was found between the number of cycles of therapy with ZOL and total patient survival (p 0.01, Pearson correlation) and time to progression (p 0.01). Pain effect of ZOL had no significant difference between the 2 groups of patients (p 0.05). Urine N-telopeptide of type I collagen (NTx) levels decreased in patients with NTx 29 nM BCE/mM creatinine at baseline after treatment with ZOL. The results of our study suggest that the addition of ZOL increases overall survival in lung cancer patients with bone metastases. The longer period of receiving ZOL, the better effect on survival and time to progression. * * 规律使用择泰?更大程度降低SREs风险 每月SREs发生率 Hatoum H T,et al. Cancer. 2008;113:1438–1445. 48% P0.05 P0.05 63% 4546例至少发生一处骨转移的恶性肿瘤患者（乳腺癌46.1%、前列腺癌34.2%和肺癌24.0%），回顾性分析择泰?使用频率和SREs发生率的关系 ＊规律使用的定义为择泰?使用4mg每3-4周一次 长期规律、使用择泰?更大程度降低SREs风险 每月发生SREs发生率(%) Hatoum H T,et al. Cancer. 2008;113:1438–1445. ＊规律使用的定义为择泰?使用4mg每3-4周一次 4546例至少发生一处骨转移的恶性肿瘤患者（乳腺癌46.1%、前列腺癌34.2%和肺癌24.0%） 回顾性分析择泰?使用频率和SREs发生率的关系 早期、规律、长期治疗 一旦确诊肺癌骨转移，即建议开始双膦酸盐治疗。 建议对于开始使用双膦酸盐的患者，应持续