放射性核素氯化锶(89Sr)联合唑来膦酸对原发性肝癌骨转移的疗效及安全性

摘要/Abstract

摘要： 目的探讨放射性核素氯化锶(⁸⁹Sr)联合唑来膦酸对原发性肝癌骨转移的疗效及安全性。方法选取2021年1月至2022年10月简阳市人民医院收治的原发性肝癌骨转移患者100例,随机分组,唑来膦酸组50例给予唑来膦酸治疗,联合组50例给予⁸⁹Sr联合唑来膦酸治疗,比较两组疗效及安全性。结果联合组总有效率为74%(37/50),较唑来膦酸组的54%(27/50)明显升高(P<0.05)。治疗后,联合组患者VAS评分为(2.65±0.76)分,低于唑来膦酸组(3.83±1.13)分,KPS评分为(82.16±8.29)分,高于唑来膦酸组(75.82±7.85)分(P<0.05)。联合组骨痛缓解开始时间为(2.62±0.37)d,早于唑来膦酸组(3.27±0.42)d,骨痛缓解持续时间(4.09±0.44)月长于唑来膦酸组(3.06±0.36)月(P<0.05);治疗后,联合组IL-6、TNF-α、血清钙、骨转化生化标志物1型前胶原氨基酸延长肽、AKP水平低于唑来膦酸组(P<0.05);联合组治疗相关不良反应总发生率为30%(15/50),唑来膦酸组为20%(10/50),差异无统计学意义(P>0.05)。结论对于原发性肝癌骨转移患者,采用⁸⁹Sr+唑来膦酸联合治疗的效果更为显著,能够减轻疼痛,消除炎性反应,改善患者机体状态及骨代谢,且安全性良好。

关键词: 原发性肝癌, 骨转移, 唑来膦酸, 放射性核素, 氯化锶, 安全性

Abstract: Objective To explore the efficacy and safety of radioactive strontium chloride (⁸⁹Sr) combined with zoledronic acid in treating primary liver cancer with bone metastasis. Methods A total of 100 patients with primary liver cancer bone metastasis were prospectively selected and randomly separated into two groups. The zoledronic acid group was treated with zoledronic acid, while the combination group was treated with ⁸⁹Sr combined with zoledronic acid. The efficacy and safety of the two groups were compared. Results The total effective rate of the combined group was 74.00% (37/50), which was greatly higher than that (54.00% (27/50) in the zoledronic acid group (P<0.05). After treatment, the visual analogue scale (VAS) score (2.65±0.76) in the combination group was lower than that in the zoledronic acid group (3.83±1.13) score, and the Karnofsky performance scale (KPS) (82.16±8.29) was higher than that in the zoledronic acid group (75.82±7.85), with statistical significance(P<0.05). The start time [(2.62±0.37) d] of bone pain relief in the combination group was earlier than that in the zoledronic acid group [(3.27±0.42) d], and the duration of bone pain relief [(4.09±0.44) month] was longer than that in the zoledronic acid group [(3.06±0.36) month] (P<0.05). After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), serum calcium (Ca²⁺), type 1 collagen amino terminal elongation peptide (TPINP), and alkaline phosphatase (AKP) in the combination group were lower than those in the zoledronic acid group (P<0.05). The overall incidence of treatment-related adverse reactions in the combination group was 30.00% (15/50), which was not greatly different from the 20.00% (10/50) in the zoledronic acid group (P>0.05). Conclusion For patients with primary liver cancer bone metastasis, the combined treatment of ⁸⁹Sr+zoledronic acid has a more great effect. It can promote pain relief, eliminate inflammatory reactions, improve physical condition and bone metabolism with a good safety.

Key words: Primary liver cancer, Bone metastasis, Zoledronic acid, Radionuclides, Strontium chloride, Safety

付钦卿, 袁钦诗, 杨夏欣. 放射性核素氯化锶(⁸⁹Sr)联合唑来膦酸对原发性肝癌骨转移的疗效及安全性[J]. 肝脏, 2025, 30(2): 222-225.

FU Qin-qing, YUAN Qin-shi, YANG Xia-xin. Analysis of the efficacy and safety of radioactive strontium chloride (⁸⁹Sr) combined with zoledronic acid in treating primary liver cancer with bone metastasis[J]. Chinese Hepatolgy, 2025, 30(2): 222-225.

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放射性核素氯化锶(⁸⁹Sr)联合唑来膦酸对原发性肝癌骨转移的疗效及安全性

Analysis of the efficacy and safety of radioactive strontium chloride (⁸⁹Sr) combined with zoledronic acid in treating primary liver cancer with bone metastasis

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