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