CAJ | 학술논문

目的观察唑来膦酸（ZA）联合化疗治疗鼻咽癌（NPC）骨转患者的临床疗效及其预后因素。方法回顾性分析306例鼻咽癌伴骨转移患者的临床资料，将患者分为唑来膦酸联合化疗治疗组（143例）及单独化疗组（163例）两组，采用Kaplan‐Meier方法及log‐rank检验验证两组总生存期（OS）及无疾病进展时间（PFS）是否存在差异。单因素及多因素分析均使用Cox回归分析。比较治疗方法、临床因素及骨相关事件（SREs）的发生率。结果唑来膦酸联合化疗治疗组与单独化疗组OS中位值分别为（24．0±1．3）个月（95％CI：21．4～26．6）及（17．0±1．7）个月（95％CI：13．6～20．4），差异有统计学意义（P＜0．001）。唑来膦酸联合化疗治疗组与单独化疗组PFS分别为（11．0±1．04）个月（95％CI：8．9～13．0）和（6．0±0．65）个月（95％CI：4．7～7．7），差异有统计学意义（P＜0．001）。唑来膦酸联合化疗治疗组骨相关事件（SREs）的发生率为25．2％，明显低于单独化疗组的42．0％，差异有统计学意义（χ2＝9．728，P＝0．002）。接受ZA治疗为OS独立的有利预后因素，而SREs、椎骨转移的发生以及高血清碱性磷酸酶（ALP）水平是OS的独立的不良因素。结论化疗联合ZA治疗能够使鼻咽癌骨转移患者生存获益。与单独化疗相比，联合治疗可以降低SREs的发生率，延长治疗PFS以及OS。
목적관찰서래련산（ZA）연합화료치료비인암（NPC）골전환자적림상료효급기예후인소。방법회고성분석306례비인암반골전이환자적림상자료，장환자분위서래련산연합화료치료조（143례）급단독화료조（163례）량조，채용Kaplan‐Meier방법급log‐rank검험험증량조총생존기（OS）급무질병진전시간（PFS）시부존재차이。단인소급다인소분석균사용Cox회귀분석。비교치료방법、림상인소급골상관사건（SREs）적발생솔。결과서래련산연합화료치료조여단독화료조OS중위치분별위（24．0±1．3）개월（95％CI：21．4～26．6）급（17．0±1．7）개월（95％CI：13．6～20．4），차이유통계학의의（P＜0．001）。서래련산연합화료치료조여단독화료조PFS분별위（11．0±1．04）개월（95％CI：8．9～13．0）화（6．0±0．65）개월（95％CI：4．7～7．7），차이유통계학의의（P＜0．001）。서래련산연합화료치료조골상관사건（SREs）적발생솔위25．2％，명현저우단독화료조적42．0％，차이유통계학의의（χ2＝9．728，P＝0．002）。접수ZA치료위OS독립적유리예후인소，이SREs、추골전이적발생이급고혈청감성린산매（ALP）수평시OS적독립적불량인소。결론화료연합ZA치료능구사비인암골전이환자생존획익。여단독화료상비，연합치료가이강저SREs적발생솔，연장치료PFS이급OS。
Objective To evaluating whether Zoledronic acid (ZA )can bring survival benefits to nasopha-ryngeal carcinoma (NPC) with bone metastases .Methods 306 patients was analyzed diagnosed NPC with bone metastases retrospectively .Divided these patients into two groups by receiving ZA or not and evalua-ted whether there exit the differences of OS and PFS between two groups by the log-rank test .The Cox multivariate analyses of clinical features and different treatment methods of the patients were conducted . Results The prevalence of SREs in the combined approach group was lower than that with chemotherapy alone (25 .2% vs 42 .0% ,χ2 =9 .728 ,P =0 .002) .The combined approach group had better progression-free survival (PFS) (11 .0 vs .6 .0 months ,P<0 .001) and overall survival (OS) than chemotherapy alone group (24 .0 vs .17 .0 months ,P <0 .001) .Cox multivariate analysis identified the following independent prognostic factors :ZA treatment ,bone metastatic sites ,baseline serum alkaline phosphatase (ALP) level and SREs .Conclusions ZA combined with chemotherapy could improve PFS and OS reduce and SREs for NPC with bone metastases .