因卡膦酸二钠联合局部单次放疗对肝细胞癌骨转移患者骨代谢、肝功能和生活质量的影响

摘要/Abstract

摘要： 目的探讨因卡膦酸二钠联合局部单次放疗对肝细胞癌(HCC)骨转移患者的疗效和安全性。方法将2022年1月至2024年3月海安市人民医院收治的HCC骨转移患者68例随机分为观察组和对照组。在常规干预和单次放疗的基础上,对照组采用唑来膦酸治疗,观察组采用因卡膦酸二钠治疗,疗程均为2个月。观察两组在骨代谢、肝功能及生理指标的变化,并对比疗效和安全性。结果治疗2个月时,观察组的血清25-羟基维生素D水平为(45.08±6.13)ng/mL,高于对照组的(40.27±5.26)ng/mL,Ⅰ型胶原交联氨基末端肽、血清骨特异性碱性磷酸酶水平为(22.93±2.75)ng/mL、(92.76±7.81)U/L,低于对照组的(26.76±3.08)ng/mL、(98.54±8.36)U/L,差异均有统计学意义(t=6.914、6.237、6.873,P<0.05);观察组的丙氨酸氨基转移酶、碱性磷酸酶、总胆红素水平为(68.42±6.18)U/L、(91.37±7.65)U/L、(17.35±2.07)μmol/L,低于对照组的(74.29±6.84)U/L、(98.63±8.04)U/L、(18.47±2.13)μmol/L,差异均有统计学意义(t=6.417、6.527、6.165,P<0.05);观察组的疼痛评分、欧洲癌症研究与治疗组织的骨转移特异子量表评分为(4.51±0.75)分、(17.46±3.08)分,低于对照组的(4.97±0.84)分、(19.38±3.25)分;观察组肿瘤患者生活质量测定量表核心量表评分为(66.59±5.71)分,高于对照组的(61.84±5.47)分,差异均有统计学意义(t=5.672、6.385、6.473,P<0.05)。观察组的客观缓解率为67.65%,高于对照组的47.06%;不良反应发生率为11.76%,低于对照组的26.47%,差异均有统计学意义(χ²=3.296、3.514,P<0.05)。结论因卡膦酸二钠联合局部单次放疗能改善HCC骨转移患者代谢和肝功能,提高生活质量,安全性较高。

关键词: 肝细胞癌, 骨转移, 因卡膦酸二钠, 局部单次放疗, 骨代谢, 肝功能

Abstract: Objective To investigate the efficacy and safety of cadronic acid disodium combined with local single radiotherapy in patients with hepatocellular carcinoma(HCC) with bone metastasis. Methods 68 HCC patients with bone metastasis admitted from January 2022 to March 2024 in Hai′an City People′s Hospital were randomly divided into an observation group and a control group. Based on routine intervention and single radiotherapy, the control group were treated with zoledronic acid, while the observation group were treated with infadronate disodium. The course of treatment was 2 months. The changes of bone metabolism, liver function, physiological indexes, efficacy and safety were observed. Results After 2 months of treatment, the serum 25-hydroxyvitamin D level in the observation group was (45.08±6.13) ng/mL, which was higher than that in the control group (40.27±5.26) ng/mL, the level of type I collagen crosslinked amino terminal peptide and serum bone-specific alkaline phosphatase were (22.93±2.75) ng/mL and( 92.76±7.81) U/L. Lower than (26.76±3.08) ng/mL and (98.54±8.36)U/L in control group, the differences were statistically significant (t=6.914, 6.237, 6.873, P<0.05). The levels of alanine aminotransferase, alkaline phosphatase and total bilirubin in the observation group were (68.42±6.18) U/L, (91.37±7.65) U/L and (17.35±2.07) μmol/L,lower than (74.29±6.84) U/L, (98.63±8.04) U/L, (18.47±2.13) μmol/L in control group, the differences were statistically significant (t=6.417, 6.527, 6.165, P<0.05). The scores of the pain scale and the bone metastases-specific subscale of the European Cancer Research and Treatment tissue in the observation group were (4.51±0.75) and (17.46±3.08) points, which were lower than those of the control group (4.97±0.84) and (19.38±3.25) points, and the core score of the quality of life scale for cancer patients was (66.59±5.71) points. It was higher than 61.84±5.47 points in the control group, and the differences were statistically significant (t=5.672, 6.385, 6.473, P<0.05). The objective remission rate of observation group was 67.65%, which was higher than that of control group (47.06%). The incidence of adverse reactions was 11.76%, which was lower than 26.47% in the control group, with statistical significance (χ²=3.296, 3.514, P<0.05). Conclusion Cadronic acid disodium combined with local single radiotherapy can improve the metabolism and liver function of HCC patients with bone metastasis and the quality of life.

Key words: Hepatocellular carcinoma, Bone metastasis, Infadronate disodium, Local single radiotherapy, Bone metabolism, Liver function

刘惠, 徐晓美, 刘晓岗, 胡亚芳, 张燕. 因卡膦酸二钠联合局部单次放疗对肝细胞癌骨转移患者骨代谢、肝功能和生活质量的影响[J]. 肝脏, 2026, 31(2): 248-252.

LIU Hui, XU Xiao-mei, LIU Xiao-gang, HU Ya-fang, ZHANG Yan. Effects of incadronate disodium combined with local single radiotherapy on bone metabolism, liver function and quality of life in patients with hepatocellular carcinoma with bone metastasis[J]. Chinese Hepatolgy, 2026, 31(2): 248-252.

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